{"id":2453,"date":"2010-04-08T11:52:41","date_gmt":"2010-04-08T11:52:41","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/prl\/"},"modified":"2025-05-14T19:08:52","modified_gmt":"2025-05-14T19:08:52","slug":"prl","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/prl\/","title":{"rendered":"Indicaciones para Tratamiento y Neurocirug\u00eda en Pacientes con Prolactinomas"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><span class=\"long_text\">A diferencia de los macroadenomas, por el que el tratamiento est\u00e1 habitualmente indicado, los microadenomas no siempre requieren tratamiento.\u00a0Para los pacientes con microadenomas que no tienen estas indicaciones, los s\u00edntomas y los niveles de prolactina deben ser monitoreados, y la RNM utilizada para seguir el tama\u00f1o del tumor.<\/span><br \/>\n<!--more--><br \/>\n<span class=\"long_text\"><strong>Indicaciones para tratamiento en pacientes con prolactinomas<\/strong><br \/>\n<\/span><\/p>\n<ul>\n<li><span class=\"long_text\">Macroadenoma<\/span><\/li>\n<li><span class=\"long_text\">Crecimiento del microadenoma<\/span><\/li>\n<li><span class=\"long_text\">Infertilidad<\/span><\/li>\n<li><span class=\"long_text\">Galactorrea molesta<\/span><\/li>\n<li><span class=\"long_text\">Ginecomastia<\/span><\/li>\n<li><span class=\"long_text\">D\u00e9ficit de testosterona<\/span><\/li>\n<li><span class=\"long_text\">Oligomenorrea o amenorrea<\/span><\/li>\n<li><span class=\"long_text\">Acn\u00e9 e hirsutismo<\/span><\/li>\n<\/ul>\n<p><span class=\"long_text\"><br \/>\nDada la eficacia del tratamiento m\u00e9dico, solo una peque\u00f1a minor\u00eda de pacientes con prolactinomas requieren cirug\u00eda transesfenoidal o radioterapia. La tasa de curaci\u00f3n\u00a0<\/span><span class=\"long_text\">quir\u00fargica<\/span><span class=\"long_text\">, son altamente dependientes de la habilidad quir\u00fargica<\/span><span class=\"long_text\">\u00a0y de la anatom\u00eda<\/span><span class=\"long_text\">\u00a0del tumor, aproximadamente 80 a 90% para microadenomas, pero menos del 50% para macroadenomas.<br \/>\n<\/span><br \/>\n<span class=\"long_text\"><strong>Indicaciones para neurocirug\u00eda en pacientes con prolactinomas\u00a0<\/strong><br \/>\n<\/span><\/p>\n<ul>\n<li><span class=\"long_text\">Incremento del tama\u00f1o del tumor a pesar del tratamiento m\u00e9dico \u00f3ptimo<\/span><\/li>\n<li><span class=\"long_text\">Apoplej\u00eda hipofisaria<\/span><\/li>\n<li><span class=\"long_text\">Intolerancia del tratamiento con agonistas de la dopamina<\/span><\/li>\n<li><span class=\"long_text\">Macroadenoma<\/span><span class=\"long_text\">\u00a0<\/span><span class=\"long_text\">resistente a los\u00a0<\/span><span class=\"long_text\">agonistas de la dopamina\u00a0<\/span><\/li>\n<li><span class=\"long_text\">Microadenoma<\/span><span class=\"long_text\">\u00a0<\/span><span class=\"long_text\">resistente a los\u00a0<\/span><span class=\"long_text\">agonistas de la dopamina\u00a0<\/span><span class=\"long_text\">en una mujer que busca fertilidad, si la inducci\u00f3n de la ovulaci\u00f3n no es apropiada<\/span><\/li>\n<li><span class=\"long_text\">Compresi\u00f3n quiasm\u00e1tica p<\/span><span class=\"long_text\">ersistente a\u00a0<\/span><span class=\"long_text\">pesar del tratamiento m\u00e9dico \u00f3ptimo<\/span><\/li>\n<li><span class=\"long_text\">Prolactinoma qu\u00edstico que no\u00a0<\/span><span class=\"long_text\">responde<\/span><span class=\"long_text\">\u00a0<\/span><span class=\"long_text\">m\u00e9dicamente<\/span><\/li>\n<li><span class=\"long_text\">En mujeres que buscan fertilidad, macroadenoma pr\u00f3ximo al quiasma \u00f3ptico a pesar del tratamiento m\u00e9dico \u00f3ptimo (<\/span><span class=\"long_text\">citorreducci\u00f3n recomendada\u00a0<\/span><span class=\"long_text\">antes del embarazo)<\/span><\/li>\n<li><span class=\"long_text\">Fuga de l\u00edquido cefalorraqu\u00eddeo durante la administraci\u00f3n de agonistas de la dopamina<\/span><\/li>\n<li><span class=\"long_text\">Macroadenoma en un paciente con una enfermedad psiqui\u00e1trica para los que est\u00e1n contraindicados los agonistas dopamin\u00e9rgicos<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Klibanski A. Clinical practice. Prolactinomas. N Engl J Med. 2010 Apr 1;362(13):1219-26.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20357284\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Molitch ME. Medical management of prolactin-secreting pituitary adenomas. Pituitary. 2002;5(2):55-65.<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12675502\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado: Abr 08, 2010<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>A diferencia de los macroadenomas, por el que el tratamiento est\u00e1 habitualmente indicado, los microadenomas no siempre requieren tratamiento.\u00a0Para los pacientes con microadenomas que no tienen estas indicaciones, los s\u00edntomas y los niveles de prolactina deben ser monitoreados, y la RNM utilizada para seguir el tama\u00f1o del tumor.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[153],"tags":[1322,74,73,1321,1320,990,973,1319,567,261],"class_list":["post-2453","post","type-post","status-publish","format-standard","hentry","category-endocrinology-and-metabolism","tag-endocrinology","tag-indicaciones","tag-indications","tag-neurocirugia","tag-neurosurgery","tag-pacientes","tag-patients","tag-prolactinomas","tag-therapy","tag-tratamiento"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2453","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2453"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2453\/revisions"}],"predecessor-version":[{"id":9353,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2453\/revisions\/9353"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2453"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2453"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2453"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}