Sex-related changes in tumor consistency in prolactinoma patients after bromocriptine pretreatment ⁎

Abstract

Abstract Objective It has long been reported that prolactinomas treated with bromocriptine increase fibrosis and may affect surgical outcomes. We retrospectively studied 238 consecutive patients with histopathologically confirmed prolactinomas undergoing microsurgery in a single neurosurgery department of Tongji Hospital (Wuhan, China) from 2012 to 2015 in order to evaluate tumor consistency changes after bromocriptine pretreatment and surgical outcomes. Methods We divided the patients into four groups: males in the dopamine agonist (DA) group, females in the DA group, males in the no DA group, and females in the no DA group, and we compared the surgery process, specimen Masson staining, and clinical outcomes of the four groups. According to a previously published classification, the operative notes from an experienced neurosurgeon were reviewed to classify the consistency of tumors as “fibrous” or “nonfibrous”. Results No differences in tumor consistency were found in male patients with or without DA treatment. However, in female patients with DA treatment, tumors were likely to be harder in texture than the tumors of female patients without DA treatment. Despite tumor consistency differences between sexes, the tumor biological remission rate was similar between groups, as was the rate of tumor resection. Discussion Our study indicates that preoperative DA therapy impacts tumor consistency in female patients but not male patients. Although the surgical and histopathological outcomes are not influenced, these findings may provide useful information for the choice of operative approach and surgery process for pituitary adenoma.