Relapse of hyperprolactinemia after transsphenoidal surgery for microprolactinoma: lessons from long-term follow-up

Neurosurgery. 2002 Jan;50(1):36-9; discussion 39-40. doi: 10.1097/00006123-200201000-00007.


Objective: The long-term results of transsphenoidal surgery for microprolactinoma, with particular reference to the question of permanence of relapse of hyperprolactinemia after biochemical cure, are examined.

Methods: Patients whose operations were performed in the city of Glasgow, Scotland, by one neurosurgeon (GMT) have been followed up for between 15 and 21 years after surgery was performed.

Results: Of a cohort of 44 patients with confirmed microprolactinoma at the time of surgery, 8 patients (18.2%) who experienced recurrent hyperprolactinemia postoperatively continued to be monitored. Selective hypophysectomy resulted in normal prolactin levels in all patients initially. Relapse occurred at 2 to 10 years (mean, 5.3 yr) postoperatively, but was permanent in only two patients (4.5%). Of the remaining six patients (13.6%), four (9.1%) became normoprolactinemic after 6 or 7 years' recurrence, and two (4.5%) are now only marginally hyperprolactinemic (prolactin >500 but <700 mU/L) at 15 and 18 years after transsphenoidal hypophysectomy.

Conclusion: The recurrence of hyperprolactinemia after transsphenoidal surgery for microprolactinoma is not necessarily a permanent feature and does not inevitably indicate operative failure.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperprolactinemia / diagnosis
  • Hyperprolactinemia / surgery*
  • Hypophysectomy*
  • Middle Aged
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery*
  • Postoperative Complications / diagnosis*
  • Prolactin / blood*
  • Prolactinoma / diagnosis
  • Prolactinoma / surgery*
  • Recurrence
  • Sphenoid Sinus / surgery


  • Prolactin