In a case of amenorrhea and galactorrhea with a pituitary tumor, what is the most appropriate management?

In cases of amenorrhea and galactorrhea associated with a pituitary tumor, particularly when the tumor is secreting prolactin (prolactinoma), the most appropriate management is the use of cabergoline. Cabergoline is a dopamine agonist that effectively reduces prolactin secretion from the pituitary gland. It acts by stimulating dopamine receptors, leading to a decrease in the size of the tumor and alleviating symptoms related to hyperprolactinemia, such as amenorrhea and galactorrhea.

Dopamine agonists like cabergoline are often the first-line treatment for prolactinomas because they can lead to tumor shrinkage and restore normal levels of prolactin in the blood, helping to restore menstrual cycles and address lactation issues. The responsiveness of prolactinomas to these medications makes cabergoline a preferred initial management option, especially in patients with symptomatic hyperprolactinemia.

While transsphenoidal surgery and radiotherapy can be effective if there is limited response to medical therapy or in cases of significant tumor mass effect, these interventions are typically reserved for more severe cases or when the patient cannot tolerate medical therapy. Craniectomy is not an appropriate option for managing pit