It is usually believed that a tumor requires an operation. However, the Consensus on the Diagnosis and Treatment of Pituitary Prolactin Adenoma in China (2014 Edition) (hereinafter referred to as the Consensus), which was officially released on August 19, 2014, clearly states that drug treatment should be preferred for pituitary prolactin adenoma. The release of this Consensus marks the beginning of a new era of drug treatment for some pituitary adenomas represented by prolactin adenomas, which will leave the scalpel behind and enter a new era of drug treatment. The Consensus on the Diagnosis and Treatment of Pituitary Prolactin Adenoma in China (2014 Edition) was officially released by the China Pituitary Tumor Collaborative Group, giving industry guidance on the diagnosis and treatment of pituitary prolactin adenoma in China. Symptoms: “mild” tumors have various manifestations Short stature and early genital development in children, enlarged fingers and toes and swollen face in adults, impotence and infertility in fertile men, amenorrhea and hypertrophy in women …… Behind these symptoms, a tumor with a “mild” appearance is likely to be hidden. The tumor is likely to be hidden behind these symptoms: pituitary tumor, which has a “mild” appearance. ”The incidence of pituitary tumors was not high in the past, but now it is estimated that the incidence of pituitary tumors in the normal population is about 10 percent.” Dr. Zhebao Wu, secretary of the China Pituitary Tumor Adenoma Collaborative Group and chief physician of the Department of Neurosurgery at Ruijin Hospital, Shanghai Jiaotong University School of Medicine, noted that this is due to increased awareness of pituitary tumors in the medical community and advances in screening tools, which have led to the detection of more patients with pituitary tumors. Pituitary tumor is one of the most common intracranial tumors and is a benign tumor. Because the tumor is located deep in the cranial brain and endocrine center, it produces pressure on the surrounding and affects the endocrine system, often causing serious damage to the patient’s growth, development, reproductive function and life and labor ability. It may cause overproduction or underproduction of endocrine hormones such as growth hormone, gonadotropin and lactogen, which may lead to gigantism and precocious puberty in children and acromegaly in adults. In addition, due to the compression by pituitary tumor, patients may also suffer from headache, loss of vision, blurred vision, diplopia and other symptoms. Misconception: over-treatment pays for itself “The disease is often misunderstood because of its low-profile personality: on the one hand, patients cannot recognize pituitary tumors in time, which leads to late detection and serious lesions; on the other hand, the domestic pituitary tumor treatment field often has problems such as non-standardized treatment.” In particular, Dr. Wu Zhebao pointed out that a common problem in China is the lack of timely updating of primary care physicians’ knowledge, which leads to serious overtreatment. “In fact, pituitary tumors do not all need to be everything. There are some pituitary tumor patients who can get their disease well controlled by taking medication.” The China Pituitary Tumor Collaborative Group emphatically calls for more emphasis on medication for invasive giant prolactin adenomas, as surgery cannot remove the tumor in its entirety and has high risks and mortality rates. According to a recent case published in the August 2014 issue of the Chinese Medical Journal, drug therapy has “unexpectedly good results” in the treatment of invasive giant prolactin adenomas. A 33-year-old male patient* from China was twice pulled back from the wrong side of surgical treatment in time to switch to medication. The patient was diagnosed with an aggressive giant prolactin adenoma in February 2013 at Ruijin Hospital of Shanghai Jiaotong University School of Medicine after 2 years of declining sexual function and blurred vision in his right eye. After taking bromocriptine for two weeks under the doctor’s guidance, the patient felt improvement in the vision of her right eye, and the tumor volume was controlled after 5 months of taking the drug. However, by the eighth month, bromocriptine showed delayed drug resistance. At this time, the patient was ready to undergo surgery again, but Ruijin Hospital prevented the surgery again and gave the drug carmeglumine treatment plan, the tumor volume began to shrink again until June 2014, the intra-saddle and intracranial tumor almost completely disappeared, achieving the ideal treatment effect. Consensus: drug therapy is the preferred option The Consensus states that bromocriptine is the drug of choice recommended for the treatment of prolactin adenoma in China because it has been proven to be safe and effective and relatively inexpensive. Compared with bromocriptine, carte blanche is more convenient to take and better tolerated by patients. However, since there is a lack of cabergoline in mainland China, it is appropriate to urge the introduction of cabergoline so that more patients can benefit. With the emphasis on the drug treatment of pituitary tumors, the Department of Neurosurgery of Ruijin Hospital of Shanghai Jiaotong University School of Medicine has opened a special pituitary tumor clinic since this year to provide better treatment options for patients from the perspective of specialized treatment. Dr. Wu Zhebao reminded that the treatment of this disease cannot be fixed and should be different from person to person. It is very unfortunate to see many pituitary tumor patients being incorrectly cut in clinical practice. “In fact, most pediatric and adolescent patients have small pituitary tumors that do not require surgery. If pituitary tumors are blindly removed, there is a risk of affecting the normal secretion of related hormones, which in turn affects growth and development, and there is a risk of complications.” According to the China Pituitary Adenoma Collaborative Group, in order to explore better new drugs, China has also been actively researching new targets related to the sensitivity of drug therapy for prolactin adenoma in recent years. Recently, Ning Guang’s team at Shanghai Key Laboratory of Endocrine Tumors discovered that the L205R hotspot mutation on the PRKACA gene is closely related to adrenocortical adenoma occurrence, thus providing a good target for drug development. It is believed that as basic research continues, one day, not only prolactin adenomas but all pituitary adenomas are expected to enter the era of drug treatment.