A 31-year-old woman has secondary amenorrhoea for 10 months, galactorrhoea, and bitemporal visual field constriction. Serum prolactin is 320 ng/mL and MRI shows a 14 mm pituitary macroadenoma. First-line management?

• A Transsphenoidal surgery
• B Octreotide
• C External beam radiotherapy
• D Cabergoline ✓

Explanation

Even macroprolactinomas are treated first with the dopamine agonist cabergoline, which suppresses prolactin secretion and shrinks tumour volume, often restoring menses and resolving visual field defects. Surgery is reserved for resistance or intolerance to dopamine agonists, and radiotherapy is a last resort. Octreotide targets somatostatin receptors and has negligible effect on prolactinomas.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.