The determination of the well-being of patients who have had the removal of a pituitary tumor prior to 1985. This will indicate how well patients have fared ten to thirty years after the surgery. The two most common causes of pituitary adenomas are prolactinoma and clinically non-functioning tumors, where each comprises about 30-40% of all tumors. Prolactinoma, a disorder of young women, is the most common of the pituitary tumors with excess secretion of a hormone. After the identification of patients who underwent pituitary surgery for removal of tumors, the interim history, including obstetrical history, history of further treatment, and recurrence of symptoms, will be evaluated. Anatomic and physiologic evidence of recurrence will be determined by physical examination. Hormone stimulation tests with insulin, metoclopromide, and thyrotropin releasing hormone (TRH) will be given to determone the reserve of pituitary hormones. To determine the anatomy of the pitutary gland, an imaging procedure (computerized tomography or magnetic resonance imaging) will be given as well as a visual field examination. A bone mineral density test will be done to tell the risk of osteoporosis. Patients will remain in the Clinical Research Center for several days. Quality of life will be evaluated by using the Nottingham Health Profile (NHP), the Hopkins Symptom Checklist (HSCL), and the Psychological General Well-Being Index. Bromocriptine has been used in the United States since 1978, lowering the serum PRL in the majority of patients. 80-90% of the patients can tolerate treatment and have reduction in serum PRL, diminution or disappearance of symptoms, and shrinkage of the tumor. But withdrwawl of the medication leads to return of symptoms and increase of the serum PRL level toward the pre-therapy level (5). There is concern that treatment for many years (perhaps 50-60), could have adverse consequences.
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