Table 2.

Preoperative and operative treatment course for patients with giant prolactinoma.

Case no	Preoperative DA dose and duration	PRL after initial DA (μg/L)	Tumor volume after initial DA (cm3)†	Indication for surgery	Surgery type	Tumor pathology features
1	N/A	N/A	N/A	Misdiagnosis, vision loss	Craniotomy, incomplete resection	Benign, diffuse PRL stain, no co-staining
2	Cab 2.5 mg/wk for 36 mos	4,156 (19% increase)	N/A–not measured	DA resistance and intolerance, vision loss, tumor apoplexy	Transsphenoidal endoscopy, incomplete resection	Benign, diffuse PRL stain, no co-staining, Ki-67 1-2% Tumor fibrosis
3	Cab 1 mg/wk for 3 mos	262 (76% decrease)	39.4 (44% increase)	DA resistance, vision loss	Transsphenoidal using microscopy, incomplete resection	Benign, diffuse PRL stain, ACTH co-staining (No co-secretion)
4	Cab 1 mg/wk for 3 weeks	172 (93% decrease)	20.0 (12% decrease)	CSF leak, DA intolerance, vision loss	Transsphenoidal using microscopy, incomplete resection	Benign, diffuse PRL stain, GH and TSH co-staining (no co-secretion)
5	Cab 2 mg/wk for 2 weeks	364 (47% decrease)	37.2 (20% increase)	DA resistance, vision loss	Transsphenoidal endoscopy, incomplete resection	Benign, diffuse PRL stain, no co-staining
6	Cab 3.5 mg/wk for 18 mos	5,754 (>56% decrease)	27.4 (11% decrease)	DA resistance and intolerance	Transsphenoidal endoscopy, incomplete resection	Benign, diffuse PRL stain, no co-staining Tumor fibrosis
7	N/A	N/A	N/A	Misdiagnosis, vision loss	Craniotomy, incomplete resection	Benign, diffuse PRL stain, no co-staining
8	Cab 3.5 mg/wk for 10 mos	1,917 (83% decrease)	23.9 (49% decrease)	CSF leak, DA resistance and intolerance	Transsphenoidal endoscopy, incomplete resection	Benign, diffuse PRL stain, no co-staining, Ki-67 20% Tumor fibrosis

^† Tumor volume calculated using geometric formula, volume = ½ (L × W × H). Cab (cabergoline), DA (dopamine agonist), PRL (prolactin), CSF (cerebrospinal fluid), ACTH (adrenocorticotrophic hormone), GH (growth hormone), TSH (thyroid stimulating hormone).