Make your own free website on Tripod.com
Click Here for Johns Hopkins Brain Tumor Radiosurgery
Home
JOHNS HOPKINS Radiosurgery
Prolactinoma Radiosurgery


JOHNS HOPKINS Pituitary Radiosurgery Appointment

Johns Hopkins Number One Hospital in USA

"Johns Hopkins
Best Hospital
In USA
1991 - 2001"




Johns Hopkins Pituitary Radiosurgery

Pituitary
Home


Pituitary
Consult


Pituitary
Newsletter


Pituitary
Appointment




Johns Hopkins Pituitary Radiosurgery



National Cancer Institute
NCI

Virtual Trials
Virtual Trials

The Brain Tumor Society
TBTS

American Brain Tumor Association
ABTA

American Cancer Society
ACS

National Brain Tumor Foundation
NBTF

For pituitary tumors, pituitary gland tumors and pituitary adenomas, please visit our site. Subscribe to the Newsletter so that we can e-mail prolactinoma information to you.
  Johns Hopkins Prolactinoma Radiosurgery / Johns Hopkins Prolactinoma Radiosurgery Please click here for our Home Page

JOHNS HOPKINS
Prolactinoma
Radiosurgery



Pituitary Tumor AppointmentsNewsletterHomepage
ReferPituitary Tumor NewsGlossaryCushings

JOHNS HOPKINS
Prolactinoma Radiosurgery

Email Dr. Jeffery Williams (jw@jhu.edu). For pituitary gland tumors including pituitary adenomas, prolactinomas and Cushings disease, the decisions related to treatment for the pituitary gland tumors depend upon the complete understanding of the competing risks vs. benefits for the different treatments. Options for pituitary gland tumor treatments may include surgery or radiosurgery. The FSR (fractionated stereotactic radiosurgery) for pituitary tumors is an important option for treatment. The important considerations include the size and rate of growth of the pituitary tumor as well as the progression of any symptoms.

Click Here for Dr. Williams C.V. Curriculum Vitae: Dr. Jeffery Williams
Director, Brain Tumor Radiosurgery
The Johns Hopkins Hospital
Board Certified: Neurological Surgery
Board Certified: Radiation Oncology
Email Dr. Jeffery Williams.

Email Address: jw@jhu.edu
Phone: 410-614-2886
Fax: 410-614-2982


Prolactinoma On-Line Discussion

  • Prolactinomas can be treated with surgery, radiotherapy, radiosurgery and/or medications.

  • For On-Line Consultation please complete and send the Patient and Tumor Info and email Dr. Williams jw@jhu.edu.

The Pituitary Tumor Mailing List

  • Join Pituitary Tumor List / Discussion Board hosted by MSN.

  • Click 'Pituitary Tumor' button for Pop Up window.

  • Read posts or join and contribute!

Prolactinoma Topics



Top of Page

Prolactinomas

Prolactinomas cause specific clinical syndromes.



Prolactinomas have specific signs and symptoms that are primarily related to the endocrinopathies produced by hypersecretion.

  • PROLACTINOMAS account for approximately 40% of pituitary tumors. Patients with these tumors have benefited from medical treatment with dopamine agonists, such as bromocriptine, which reduce tumor volume and return prolactin (PRL) secretion to normal concentrations in 80% of cases. However, surgery is widely used to avoid the side effects of this treatment and to handle bromocriptine-resistant prolactinomas. Advances in pituitary surgery involving use of the rhinoseptal route have led to a definitive cure in 62 to 89% of patients with microprolactinomas. However, there has been no early and reliable predictive index to ascertain whether surgery has been successful. Some factors, such as high preoperative concentrations of PRL, the presence of an invasive tumor, and the age of the patient at the time of surgery, have been reported to be factors in surgical failure.

  • Dopamine agonists stimulate pituitary dopamine (D2) receptors, which results in the suppression of prolactin secretion. In most patients with prolactin-producing pituitary adenoma, dopamine agonists decrease blood prolactin levels, improve the clinical symptoms, and cause a marked tumor shrinkage accompanied by normalization of any visual defects. Some patients with prolactin-producing pituitary adenoma fail to respond to dopamine agonist medication. The frequency and causes of this resistance to dopamine agonist therapy are not known.


Top of Page
Microsurgical resection of prolactinomas can be done via two approaches.

Microsurgical resection of prolactinomas can be done via two approaches.

  • The transphenoidal approach allows resection of small to medium-sized prolactinomas. The risks of surgery include CSF (spinal fluid leak) and meningitis. The rates of these complications are low, however.

  • The pterional approach allows greater visualization and exposure of larger prolactinomas.

Top of Page

Stereotactic Radiosurgery offers non-invasive control of newly diagnosed or recurrent prolactinomas.

Stereotactic Radiosurgery allows specific irradiation of only the prolactinoma. Narrow beams of radiation specifically target only the prolactinoma. The normal brain is spared and does not receive significant exposure. For treatment there are no "pins" placed in the scalp as with single fraction techniques. The treatment results in control of the majority of prolactinomas and their endocrinological sequelae. Stereotactic radiosurgery may be particularly suitable for functional pituitary adenomas (prolactinomas) to reduce the level of hormonal secretion. For recurrent pituitary adenomas after conventional surgery and radiation, stereotactic radiosurgery is particularly appropriate, allowing sparing of the optic nerves with delivery of high radiation dose to the recurrent prolactinoms.

The patient information may be submitted.

Stereotactic Radiosurgery offers specific, local treatment to the prolactinoma with sparing of surrounding normal tissues.


Top of Page


Prolactinoma Patient and Tumor Information

The form below may be of interest to patients who have prolactinoma. It outlines many of the important questions related to prolactinoma and its treatment. The treatment options for prolactinomas are multi-factorial and depend upon many different characteristics of the patient and the tumor. The form can be sent to Dr. Williams using the "Send Form" button at the end of the page. Dr. Williams can subsequently correspond regarding the issues related to the treatment options for prolactinomas. This information helps determine which of the different therapies may be helpful for treatment. Even though all of the information below may not be available, please submit all that is known.

There are two ways to relay the information:

  • Email Dr. Williams regarding Prolactinoma treatment options: Dr. Jeffery Williams

  • Send the form and include your email address in the box at right (if response is desired):

  • Top of Page

Please enter the responses and click on the "Submit Form" button at the end of this form.

Date of Diagnosis

What is the DATE of the diagnosis of the pituitary adenoma?





  • Method of Diagnosis

    How was the first prolactinoma diagnosed?

    Craniotomy

    Endocrine studies (blood tests)

    Radiographically and blood tests





  • Location

    What was the location of the pituitary adenoma?

    Sella Turcica (Normal Location)

    Extension beyond sella (suprasellar or into cavernous sinus(es))




  • Size: What is the size of the pituitary adenoma (largest dimension)?

    Less than one centimeter

    Greater than one, but less than two centimeters

    Greater than two, but less than three centimeters

    Greater than three centimeters





  • Endocrine Studies

    Does the patient have above-normal secretion of any hormone(s) (most importantly Prolactin) by the pituitary pituitary adenoma as documented by laboratory studies?

    No

    Yes


    (Please list hormone(s):

    ACTH

    Prolactin

    Growth Hormone

    Other:





  • Syndromes

    Does the patient have either of the following syndromes?

    Cushings Disease

    Acromegaly

    Hyperprolactinemia





  • First (Prior) Treatment (if applicable): How was the first prolactinoma treated?

    Observation Only

    Medication

    Subtotal Resection

    Total Resection

    Surgery (subtotal or total) and radiation





  • Date First Treatment

    What was the DATE of the treatment for the FIRST prolactinoma?







Current Prolactinoma
  • What is the DATE of the DIAGNOSIS of the CURRENT prolactinoma (if current is different from above)? This prolactinoma is for consideration for the CURRENT radiosurgery or surgical resection.





  • Growth of Tumor

    Has the prolactinoma GROWN in size since a prior treatment or initial diagnosis?

    No

    Yes





Surgical Management of Current Prolactinoma
  • Prior to Radiosurgery, if given, how is the CURRENT prolactinoma (or group of pituitary adenomas) surgically treated?

    Subtotal Resection

    Total Resection

    No Surgery






Histology:
  • Please enter the histology:

    Benign

    Malignant

    Atypical

    Other (not listed above):




Thank you for completing the Johns Hopkins Prolactinoma Questionnaire.

Top of Page





Click Here for Johns Hopkins Brain Tumor Radiosurgery

© Copyright 2001 • All Rights Reserved • The Johns Hopkins University
Johns Hopkins Radiosurgery
Harvey 811, 600 North Wolfe Street, Baltimore, MD 21205-8811
410-614-2886 (phone) • 410-614-2982 (fax) • jw@jhu.edu


Disclaimer and Privacy

Pituitary Tumor AppointmentsNewsletterHomepage
ReferPituitary Tumor NewsGlossaryCushings