The Effect of Gamma Knife Radiosurgery for the Infertile Females who have Prolactin Secreting Pituitary Adenoma

Lyo, In Uk; Bae, Jun Suk; Lee, Doo Hee; Kim, Soon Young; Kim, Jeong Hoon; Kwon, Yang

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2005;1(1):68-72.
Published online June 30, 2005.

The Effect of Gamma Knife Radiosurgery for the Infertile Females who have Prolactin Secreting Pituitary Adenoma

In Uk Lyo, Jun Suk Bae, Doo Hee Lee, Soon Young Kim, Jeong Hoon Kim, Yang Kwon

Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea

Abstract

Objective
The purpose of this retrospective study is to evaluate the effect of Gamma Knife radiosurgery (GKRS) in the treatment for the infertile females who have prolactin secreting pituitary adenoma (prolactinoma) and want to have pregnancy. Method: Seventy five patients with pituitary adenoma have been treated with GKRS in our institute from May 1990 to December 2002. Among them, twenty seven female patients had prolactinoma. This study comprised 8 patients of 21-35 ages considered as reproductive ages followed clinical symptoms, changes of serum prolactin level and pregnancy after radiosurgery.
Results
The initial clinical presentation was amenorrhea (8 cases), amenorrhea with galactorrhea (6 cases). Clinical improvement in follow-up was present in all 8 patients. All patients showed the menstruation and decreased serum prolactin level. Three cases (28%) were less than 25ng/ml, 4 cases (57%) were within 25-150ng/ml, and 1 (14%) was more than 150ng/ml. Six patients had taken the bromocriptine after radiosurgery. Reduced the tumor size in MRI occured in 1 case (14%), whereas 3 cases (42%) of no change and 1 (14%) increased. All 8 patients (100%) who were willing to be pregnant had given birth to heath children who were free of congenital anomalies in mean 1.7 years after GKRS. Four patient had one child and 4 had 2 children.
Conclusion
GK radiosurgery in the treatment for infertile females who had prolactinoma seem to be effective as primary and/or adjuvant therapy after microsurgery, and the patients are able to be pregnant whose serum prolactin level after radiosurgery was higher than normal with bromocriptine administration.

Key Words: Radiosurgery, Prolactinoma, Pregnancy.