Document Detail


Effect of dopaminergic drug treatment on surgical findings in prolactinomas.
MedLine Citation:
PMID:  20878243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been reported that prolactinomas treated with Bromocriptine (BROM) show fibrosis that may interfere with complete surgical resection. The same has not been reported for Cabergoline (CAB). We retrospectively studied 24 consecutive patients (13 females, mean age 40 years, range 16-60) with histopathologically confirmed prolactinomas undergoing surgical resection at Johns Hopkins Hospital between 1992 and 2009. We compared these prolactinomas to 34 patients (22 females, mean age 42.9 years, range 15-75) with GH-secreting adenoma. The operative notes from 7 different neurosurgeons were reviewed to catalog the tumors as fibrous or not fibrous. Of the 24 prolactinomas, 21 (87.5%) were previously treated with DA. Indication for surgery was: DA resistance (n.5), DA intolerance (n.6), persistent mass effect (n.7) and CSF leak (n.3). Five (14.7%) of GH-secreting adenomas, were exposed to DA and/or somatostatin analogs. We found that 54% of prolactinomas and only 6% of GH-secreting adenomas were described as fibrous. 10/12 (77%) of prolactinomas exposed to BROM for at least 1 month, 2/9 (22%) exposed to CAB only, and 1/3 (33%) not previously treated were fibrous (P < 0.05). The mean BROM cumulative dose was 406 mg (range 75-1,375), while CAB dose was 28 mg (range 6-70). Only 18% of non-fibrous prolactinomas had been exposed to BROM. Only 3 patients had persistent biochemical remission (2 treated with CAB and 1 not treated). Patients exposed to BROM for at least 1 month are more likely to have tumor fibrosis than patients that are untreated or treated with CAB.
Authors:
Maria Menucci; Alfredo Quiñones-Hinojosa; Peter Burger; Roberto Salvatori
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pituitary     Volume:  14     ISSN:  1573-7403     ISO Abbreviation:  Pituitary     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-07-01     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-74     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Endocrinology, Johns Hopkins University, Baltimore, MD 21287, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / drug therapy,  pathology,  surgery
Adolescent
Adult
Aged
Bromocriptine / therapeutic use
Child
Dopamine Agents / therapeutic use*
Ergolines / therapeutic use*
Female
Humans
Male
Middle Aged
Pituitary Neoplasms / drug therapy,  pathology,  surgery
Prolactinoma / drug therapy*,  pathology,  surgery
Retrospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Dopamine Agents; 0/Ergolines; 25614-03-3/Bromocriptine; LL60K9J05T/cabergoline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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