Young women with secondary amenorrhoea and galactorrhoea. MRI shows a tumor of < 10mm diameter in the pituitary fossa. Treatment is -

A young woman with Amenorrhoea-galactorrhoea syndrome demonstrating a tumour of <10 mm in diameter in pituitary fossa confirms the diagnosis of prolactinoma. Pituitary adenoma < 10 mm in diameter→ Microadenome > 10 mm in diameter.→ Macroadenoma REMEMBER   Mass effects of pituitary adenoma can only be seen when they are greater than 10 mm. T/T of prolactinoma. The t/t of choice for prolactinomas is bromocriptine. Bromocriptine is a dopamine agonists which inhibits the secretion and synthesis of prolactin. Under the influence of Bromocriptine, the tumours decreases in size within days, the prolactin level falls, and the visual field defect improves. The surgical tit is Transphenoidal microsurgical approach with an attempt at total removal of the tumours. Indications for surgery in case of prolactinoma. Dopamine resistance or intolerance. Presence of invasive macroadenoma with compromised vision that fails to improve rapidly after drug treatment. Prolactin, normalization is seen in 70% microadenomas after resection, but only 30% of macroderma can be successfully resected.