Pituitere adenome (prolaktinome) en amenoree-galaktoree
The original publication is available at http://www.samj.org.za
The syndrome of amenorrhoea-galactorrhoea has been known for years, but new diagnostic methods opened up a new approach to the treatment of patients with this syndrome. Whether the increasing awareness of hyperprolactinaemia is due only to the impact of these newer diagnostic methods, or whether there is an increasing incidence due to modern civilization, is unsettled. The clinical picture is variable and therefore a high-risk group should be delineated, namely those patients with amenorrhoea-galactorrhoea and hyperprolactinaemia. Since this condition responds very well to treatment with bromergocriptine, and since there is a 5% (micro-adenomas) -35% incidence of tumour extension during pregnancy, this high-risk group should be scrutinized for a possible pituitary adenoma. The treatment of pituitary adenoma is at the present stage best labelled as an emotional matter, more particularly for micro-adenomas. This is certainly so for the patient not interested in pregnancy. The long-term outcome in patients with hyperprolactinaemia effectively treated with bromergocriptine is not known. The group with macro-adenomas interested in pregnancy should be treated by some form of destructive procedure. For the rest, the future will tell.