A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

Background: Complete tumor elimination via transsphenoidal surgical operation is frequently hard for large nonfunctioning pituitary adenomas (NFPAs). A confirmed medical treating might be beneficial for their managing. Aim of Study:To investigate the effectiveness of dopamine agonist medication in decreasing or avoiding the re-growing of NFPA after ward surgical operation.Patients and Methods: This was a prospective, randomized, clinical trial done in Al-Azhar University Hospitals was conducted on 20 patients experienced primary transsphenoidal surgical operation for pituitary adenoma management, the study was carried out through a period of 12 months from March 2020 to March 2021.Results: Tumour reduction rate of remaining cancer mass was significantly higher in medically-treated group, while tumour growing rate of remaining tumour mass was significantly elevated in controls. Conclusion:Cabergoline (dopamine agonist was an effective medication for the treatment of remaining NFPA, and its usage was accompanying with an elevated tumour shrinkagerates.

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“…Mass impact and hypopituitarism cause elevated morbidity and death. But early diagnosing and powerful therapy reduces morbidity and death [17] .…”

Section: Discussionmentioning

confidence: 99%

Post-Operative Use of Dopamine Agonist in Management of Remaining Nonfunctioning Pituitary Adenoma

Ayad

Ahmed²

2021

The Medical Journal of Cairo University

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“…Stereotactic radiotherapy is used to treat and prevent recurrences as well as to reduce the size of postsurgical remnants ( 13 , 15 ). Pharmacological therapy with somatostatin receptor ligands and/or dopamine agonists has not been demonstrated to be effective in reducing tumor size ( 13 , 16 , 25 ). In a recent publication, DAs were considered in patients with NFPA with incompletely resected tumors, as the authors demonstrated that DA therapy may prevent residual tumor enlargement in over 85% of patients with NFPA ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Non-functioning pituitary adenomas and pregnancy: one-center experience and review of the literature

Rosmino¹,

Tkatch²,

Paolo³

et al. 2020

Archives of Endocrinology and Metabolism

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The usual clinical presentation of non-functioning pituitary adenoma (NFPA) consists of symptoms of mass effect and hypopituitarism. NFPA is a rare condition in young women and an uncommon complication during pregnancy. We present the outcome of three patients with NFPA during pregnancy. Case 1: a 38-year-old woman was referred at 32 nd week of spontaneous pregnancy because of diagnosis of a pituitary macroadenoma discovered in the context of progressive visual loss. Hormonal deficiency and hypersecretion were ruled out. Prolactin levels were high as expected. She developed diplopia and severe headache despite the use of dopamine agonists and corticosteroids, so pregnancy was interrupted at 34 th week. After an uncomplicated delivery of a healthy newborn, transsphenoidal surgery was performed. The pathology was consistent with a gonadotroph adenoma. She recovered visual field, and remained with normal pituitary function. Postsurgical tumor remnant increased in size during the follow-up. Case 2: a 34-year-old woman was referred due to secondary amenorrhea and galactorrhea. A macroadenoma with suprasellar extension was discovered. Transsphenoidal surgery confirmed a gonadotroph adenoma. Two years after surgery she had a normal pregnancy. Six years after surgery a small tumor recurrence occurred. Case 3: a 23-year-old woman was referred due to a microincidental pituitary adenoma. Laboratory testing was normal. No findings on physical examination. A wait and see approach was decided. Two years after diagnosis, the patient got pregnant without complications. Image remained stable. This article may contribute new cases and provides an extensive review of NFPA during pregnancy.

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“…2,[14][15][16] Pasien kami mengalami hilangnya penglihatan mata kanan disertai nyeri kepala kronis ketika masuk rumah sakit. Selain itu, pasien juga mengalami hiperprolaktinemia 198,10 ng/mL (nilai referensi 2,1-17,1 ng/mL) 12,15,17 Pada pasien ini, pemeriksaan prolaktin dengan dilusi 1:100 tidak dilakukan. Modalitas terapi untuk makroadenoma hipofisis dengan hiperprolaktinemia terdiri dari terapi farmakologi dengan agonis dopamin seperti bromokriptin dan kabergolin, operasi EETA, serta radioterapi.…”

Section: Pembahasanunclassified

Laporan Kasus: Perbaikan Kadar Prolaktin pada Makroadenoma Hipofisis dengan Terapi Bromokriptin dan EETA

Gayatri

Hidayati

2020

ijcp

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Hiperprolaktinemia merupakan salah satu gejala klinis yang umum terjadi pada kasus makroadenoma hipofisis. Hiperprolaktinemia yang terjadi pada makroadenoma hipofisis dapat disebabkan oleh adanya penekanan massa tumor terhadap infundibulum (pituitary stalk) atau adanya sekresi hormon oleh tumor. Penelitian ini bertujuan untuk membahas pengaruh pemberian terapi bromokriptin dan operasi Endoscopic Endonasal Transsphenoidal Approach (EETA) terhadap perbaikan kadar hormon prolaktin dan kondisi klinis pada kasus makroadenoma hipofisis dengan hiperprolaktinemia. Dalam laporan kasus ini, dilaporkan bahwa seorang remaja pria usia 17 tahun datang dengan hilangnya penglihatan mata kanan, nyeri kepala, sulit menelan, dan ginekomasti. Pemeriksaan Magnetic Resonance Imaging (MRI) otak dengan kontras didapatkan adanya lesi ekstra aksial supratentorial di intrasellar yang meluas hingga suprasellar. Pada pemeriksaan laboratorium didapatkan adanya hiperprolaktinemia 198,10 ng/mL (nilai referensi 2,1-17,1 ng/mL). Hiperprolaktinemia yang terjadi pada kasus ini dapat disebabkan oleh tumor hipofisis yang mensekresi prolaktin (prolaktinoma) dan/atau akibat dari pendesakan massa tumor terhadap infundibulum. Berdasarkan hasil anamnesis, pemeriksaan fisik, pemeriksaan laboratorium dan penunjang, pasien didiagnosis mengalami makroadenoma hipofisis. Kami mempresentasikan kasus perbaikan kondisi klinis dan total penurunan kadar prolaktin sebesar 79,70% (pre pengobatan 198,10 ng/mL, post pengobatan 40,20 ng/mL) pada pasien dengan makroadenoma hipofisis yang disertai hiperprolaktinemia setelah dilakukan pemberian terapi bromokriptin 2,5 mg per hari selama 14 hari masa perawatan di rumah sakit dan tindakan operasi EETA.

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A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

Cited by 24 publications

References 147 publications

Post-Operative Use of Dopamine Agonist in Management of Remaining Nonfunctioning Pituitary Adenoma

Post-Operative Use of Dopamine Agonist in Management of Remaining Nonfunctioning Pituitary Adenoma

Non-functioning pituitary adenomas and pregnancy: one-center experience and review of the literature

Laporan Kasus: Perbaikan Kadar Prolaktin pada Makroadenoma Hipofisis dengan Terapi Bromokriptin dan EETA

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