Rapid Improvement of Visual Defects with Parenteral Depot-Bromocriptine in a Patient with a Non-Functioning Pituitary Adenoma

García-Luna, Pedro Pablo; Leal‐Cerro, Alfonso; Pereira, Jorge Luís Gavina; Montero, Carmen; Acosta, Diego Andres Velasco; Trujillo, Francisca; Mazuelos, C.; Astorga, R.

doi:10.1159/000181286

Cited by 4 publications

(1 citation statement)

References 22 publications

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“…Reduction of the plasma hormone level by bromocriptine treatment was reported in a few patients with gonadotropinoma (5,(21)(22)(23). A few case reports have suggested that the occasional nonfunctioning pituitary tumor maydecrease in size in response to dopamine agonist treatment (24)(25)(26)(27)(28). Almost all of these tumors are likely to be gonadotropinomas, because the majority of clinically nonfunctioning pituitary adenomas are gonadotropinomas (3,4).…”

Section: Discussionmentioning

confidence: 99%

Reduction of Plasma Gonadotropin Levels and Pituitary Tumor Size by Treatment with Bromocriptine in a Patient with Gonadotropinoma.

et al. 1999

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Apituitary tumor with suprasellar extension was found by magnetic resonance imaging (MRI) in a male with diabetes mellitus. Endocrine examination revealed high plasma folliclestimulating hormone (FSH) and a-subunit levels, which increased with administration of thyrotropin (TSH)-releasing hormone (TRH). Plasma luteinizing hormone (LH) and testosterone levels were low. Pituitary gonadotropin producing tumor was diagnosed. Because the patient refused surgery, bromocriptine was administered and plasma FSH and a-subunit rapidly decreased; on MRIthe tumor size was gradually reduced. Whenpituitary operation is not feasible, bromocriptine is one choice of treatment. (Internal Medicine 38: 266-271, 1999)

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Section: Discussionmentioning

confidence: 99%

Reduction of Plasma Gonadotropin Levels and Pituitary Tumor Size by Treatment with Bromocriptine in a Patient with Gonadotropinoma.

et al. 1999

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Losa

Mortini

Barzaghi

et al. 2001

Journal of Neuro-Oncology

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Endocrine inactive pituitary adenomas represent about one quarter of all pituitary tumors. By immunocytochemistry, most of these tumors are positive for intact gonadotropins and/or their subunits. Clinical presentation is usually secondary to mass effect symptoms, such as visual disturbances, headache, and hypopituitarism. Differential diagnosis is usually accomplished by neuroradiologic studies, even though in selected cases positron emission tomography and/or single photon emission tomography may aid to distinguish pituitary adenomas from other endocrine inactive lesions, such as meningiomas and craniopharyngiomas. Surgical management is usually considered the first choice treatment for patients with endocrine inactive pituitary adenomas because it is very effective in ameliorating symptoms of chiasmal compression and headache. Radical removal of the tumor, however, is difficult to obtain because of the frequent invasiveness into the cavernous sinus. Radiation therapy diminishes the likelihood of tumor recurrence, especially in patients with demonstrable tumor remnants after surgery. Medical therapy with dopaminergic drugs, somatostatin analogs, or gonadotropin-releasing hormone agonists or antagonists causes mild reduction of tumor size in few patients and, therefore, seems to be of limited value in the therapeutic management of patients with endocrine inactive pituitary adenomas.

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Medical therapy for clinically non-functioning pituitary adenomas

Colao¹,

Somma

Pivonello³

et al. 2008

Endocrine Related Cancer

169

101

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Surgery is the first-line treatment of patients with clinically non-functioning pituitary adenomas (NFAs). Because of lack of clinical syndrome these tumours are diagnosed with a variable delay, when patients suffer from compression symptoms (hypopituitarism, headache and visual field defects) due to the extension of the tumour outside the pituitary fossa. Surgery is followed by residual tumour tissue in most patients. In these cases, radiotherapy is generally used to prevent tumour regrowth. However, NFA cell membranes, in analogy with GH-and PRL-secreting adenomas, express somatostatin and dopamine receptors. Treatment with somatostatin analogues (SSA) and dopamine agonists (DA) induced some beneficial effects on visual field defects and was also followed by tumour shrinkage in a minority of cases. DA seem to be more effective on tumour shrinkage than SSA. More recently, a combination treatment with both SSA and DA have been tested in a few patients with interesting results. Lack of randomized, placebocontrolled trials prevents any conclusion on the efficacy of these drugs. By contrast, use of gonatotrophin-releasing hormone analogues has been abandoned. Endocrine-Related Cancer (2008) 15 905-915

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Rapid Improvement of Visual Defects with Parenteral Depot-Bromocriptine in a Patient with a Non-Functioning Pituitary Adenoma

Cited by 4 publications

References 22 publications

Reduction of Plasma Gonadotropin Levels and Pituitary Tumor Size by Treatment with Bromocriptine in a Patient with Gonadotropinoma.

Reduction of Plasma Gonadotropin Levels and Pituitary Tumor Size by Treatment with Bromocriptine in a Patient with Gonadotropinoma.

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Medical therapy for clinically non-functioning pituitary adenomas

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