A 34-year-old woman presents with amenorrhea, galactorrhea, and a prolactin level of 210 ng/mL. MRI pituitary shows a 12 mm intrasellar lesion. Which of the following is the most appropriate first-line treatment?
- A Transsphenoidal surgery
- B Bromocriptine or cabergoline ✓
- C High-dose glucocorticoids
- D Radiation therapy
Correct answer: B. Bromocriptine or cabergoline
Explanation
Dopamine agonists (bromocriptine, cabergoline) are the first-line treatment for prolactinomas regardless of size, as prolactin secretion is under tonic dopaminergic inhibition. Cabergoline is preferred for its superior efficacy and tolerability. Surgery is reserved for those who are intolerant or refractory to dopamine agonists, or for tumors causing acute vision loss.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.