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Due to increased risk of morbidity and mortality, surgical resection of these large prolactinomas should be restricted to those with apoplexy or CSF leakage or to patients with progressive mass growth despite optimal treatment (strong)

Arrieta O, Hernandez-Pedro N, Fernandez-Gonzalez-Aragon MC, et al

Anti-Inflammatory & Cytoprotective Action Reduces levels of pro-inflammatory cytokines (TNF-, IL-6) and oxidative stress markers, supporting recovery across multiple tissue types

NETs can capture circulating tumor cells and facilitate metastases (Kumar and Dikshit 2019

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Alternatively, Ipamorelin increases growth hormone release by selectively activating the ghrelin receptor without affecting other hormones