A 45-year-old woman presents with progressive frontal headache, bitemporal hemianopsia, and amenorrhea for 8 months. Vital signs show BP 128/82 mmHg, HR 78/min, RR 14/min, temperature 37°C. Serum prolactin is elevated at 185 ng/mL; TSH and cortisol are normal. MRI demonstrates a 2.2 cm sellar mass with optic chiasm compression. Visual acuity remains intact. She takes no hormonal medications. Which of the following is the most appropriate initial management?
- A)Dopamine agonist therapyGABARITO
- B)Combined hormonal contraceptive therapy
- C)Transsphenoidal surgery immediately
- D)Radiation therapy
- E)Bromocriptine followed by surgery in 3 months
Explicação
Prolactinomas are the most common functional pituitary adenomas. Medical management with dopamine agonists (bromocriptine or cabergoline) is first-line for most patients, including those with macroadenomas, as they shrink tumors and relieve symptoms in 80-90% ... Ver explicação completa e trilha adaptativa →