Endoscopic endonasal transsphenoidal hypophysectomy in an adult male patient with prolactinoma acromegaly who did not respond to bromocriptine therapy: a case report

Background: The most common pituitary tumor, prolactin-secreting tumors (prolactinomas), have a frequency of females between the ages of 20 and 50 are the most likely to experience the condition with the female to male ratio is roughly 10:1. However, up to 4% of well-controlled prolactinoma patients can develop acromegaly. This case report aims to present a case of prolactinoma acromegaly male patient underwent endoscopic endonasal transsphenoidal hypophysectomy. Case Presentation : A 29-year-old male patient with a diagnosis of pituitary macroadenoma due to prolactinoma with clinical symptoms of acromegaly has been treated previously with bromocriptine for three years, but the size of the tumor in this patient is getting bigger and causing visual field disorders so that this patient is performed endoscopic endonasal transsphenoidal hypophysectomy. After the surgery, the patient had a period of diabetes insipidus during treatment in the intensive care unit (ICU) and the patient's visual field improved. Patient’s condition has improved following the surgery. Conclusion: Patients with prolactinoma acromegaly treated mainly with bromocriptine to decrease prolactin production and so shrink the tumor. Nevertheless, endoscopic endonasal transsphenoidal hypophysectomy approach is applied if pharmacological therapy has not been effective.