Treatment
is
indicated
if
mass
effects
from
the
tumor
and
/
or
____________________
effects
from
hyperprolactinemia
are
present
.
Bromocriptine
(
BEC
)
is
generally
____________________
to
be
the
agent
of
choice
in
the
____________________
of
prolactinoma
because
of
its
long
track
record
and
____________________
.
As
a
dopamine
(
DA
)
agonist
,
it
decreases
the
synthesis
and
secretion
of
PRL
.
It
also
decreases
the
rate
of
tumor
cell
division
and
the
growth
of
individual
cells
.
Other
medical
treatments
for
prolactinomas
are
____________________
for
patients
who
do
not
respond
to
BEC
or
for
those
who
cannot
tolerate
the
drug
.
Cabergoline
,
____________________
ergot
derivative
,
is
a
long
-
acting
DA
agonist
and
is
available
in
the
United
States
.
In
those
patients
with
DA
agonist
?
resistant
prolactinomas
(
DARPs
)
____________________
persistent
hyperprolactinemia
despite
surgical
debulking
,
with
or
without
radiotherapy
,
temozolomide
,
a
____________________
alkylating
agent
,
has
been
recommended
.
Transsphenoidal
pituitary
adenomectomy
is
the
____________________
surgical
treatment
in
____________________
with
microprolactinoma
and
in
most
patients
with
macroprolactinoma
.
A
combination
of
surgery
followed
by
____________________
medical
treatment
with
BEC
or
one
of
the
other
agents
is
____________________
in
patients
with
incomplete
resolution
of
elevated
PRL
levels
and
in
persons
with
____________________
tumors
seen
on
follow
-
up
imaging
studies
.
