Dopamine Agonists for Pituitary Adenomas

Cooper, Odelia; Greenman, Yona

doi:10.3389/fendo.2018.00469

Cited by 37 publications

(25 citation statements)

References 96 publications

(111 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…70%) was also reported in the other studies [27,28]. These results corroborate with the reported efficacy of the postoperative treatment of CNFPAs with dopamine agonists [27,29,30]. Our observation that the expression of RD2 concerns equally PRL-positive as PRL-negative CNFPAs suggests that the latter are also good candidates for the treatment with dopamine agonists.…”

Section: Discussionsupporting

confidence: 91%

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas

Winczyk

Toszek

Świętosławski

et al. 2020

Folia Histochem Cytobiol.

View full text Add to dashboard Cite

Introduction. Approximately one third of pituitary adenomas are manifested neither by specific symptoms of hormone overproduction nor by elevated blood levels of pituitary hormones. However, these tumours, diagnosed before surgical intervention as clinically non-functioning pituitary adenomas (CNFPAs) express in majority different pituitary hormones, as can be revealed by means of immunohistochemical examination. One of the pituitary hormones which may be expressed in CNFPAs is prolactin (PRL) but the clinical and pathological data on this condition are very scarce. Material and methods. Sixty two pituitary adenomas, diagnosed before surgery as CNFPAs, were immunoassayed with antibodies against PRL, growth hormone (GH), luteinizing hormone (LH), follicle stimulating hormone (FSH), thyrotropin (TSH), alpha subunit (alpha-SU), corticotropin (ACTH) and dopamine receptor type 2. In a proportion of the patients the presurgical concentrations of insulin-like growth factor 1 (IGF-1) were estimated by means of enzyme-amplified chemiluminescence assay. Results. Twenty-three (37.1%) of the examined CNFPAs presented the positive immunoreaction with anti-PRL antibody. Most cases concerned women. Only in two cases (one woman and one man), PRL was the unique hormone expressed in the tumour. In the remaining adenomas PRL immunopositivity was accompanied by GH expression-17, LH or free bLH-13, FSH-2, free a subunit-4 or by ACTH-5 tumours. Seven (30.43%) of them were recurrent in comparison with 12.8% PRL-immunonegative recurrent CNFPAs. Dopamine receptors were positively immunostained in all the investigated PRL-immunopositive and all PRL-immunonegative adenomas. Conclusions. Our data confirm the observations that monohormonal silent prolactinomas are very rare but frequently silent PRL often co-expressed with GH or LH. Although in the whole population of patients with CNFPAs both sexes are equally represented, in the case of silent prolactinomas the female sex is prevalent. The observation of the higher rate of recurrent tumours within PRL-immunopositive adenomas versus PRL-immunonegative CNFPAs has to be confirmed on the larger material.

show abstract

Section: Discussionsupporting

confidence: 91%

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas

Winczyk

Toszek

Świętosławski

et al. 2020

Folia Histochem Cytobiol.

View full text Add to dashboard Cite

show abstract

“…Good response to DA was observed more in males as all our patients (100%) that totally cured and had no residual mass during follow up were males and 20% of patients that had tumor reduction were males. Cooper and Greenman [13] reported the largest series of NFPT patients who were treated with DA. In one of the groups that they studied, fifty five patients received preventive DA treatment and twenty four patients received treatment after tumor growth.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Use of Dopamine Agonist in Controlling the Residual Mass in Non Functioning Pituitary Adenoma

Mahmoud¹,

Moussa²,

Abokresha³

et al. 2020

OJMN

View full text Add to dashboard Cite

Background: Non-functioning pituitary adenoma (NFPA) is a challenging tumor. It is usually reached to a large size before it is clinically manifested. Operative interference is the first option in treatment of large NFPA causing compressive manifestations but with frequent postoperative residual masses that is usually required additional treatment. Postoperative radiotherapy carried frequent side effects which open the door for postoperative medical treatment with dopamine agonist (DA) drugs based on the fact that these tumors have a variable amount of dopamine receptors. Lack of randomized, placebo-controlled trials prevents any conclusion on the efficacy of this drug. Its role in controlling postoperative proliferation and decreasing the rate of recurrence of NFPA is still questionable. Objective: Efficacy of bromocriptine (dopamine agonist (DA) drug) in reducing or preventing the re-growth of non-functioning pituitary adenoma NFPA after surgery. Methods: In this study, we examined the outcome of treating NFPA after surgery, with bromocriptine (dopamine agonists drug). This study was a retrospective review of consecutive patients that were treated by the authors at Assiut University Hospital between 2012-2018. All patients had postoperative Bromocriptine in a dose of 2.5 mg twice daily. Results: Thirty two patients were included in this study after they had surgery for NFPA. All patients had a residual mass documented by the immediate post operative MRI. After 6 months of postoperative bromocriptine treatment, and with comparing to immediate post operative images, eleven patients (34%) had mass reduction, thirteen patients (41%) of their residual masses remained unchanged and eight patients (25%) of the mass showed slight increase in size but not required re-surgery. After two years and throughout the follow up period, seven patients (22%)

show abstract

“…In contrast, Ferriere et al [224], who conducted a multicenter retrospective study of 53 CD patients, showed that about 20–25% of CD patients showed good response to cabergoline therapy, allowing the long-term control of hypercortisolism at relatively low dosages (1.5 mg/week) and with acceptable tolerability. In those responders, metabolic symptoms associated with CD resolved and tumor size decreased or remained stable [225]. However, even in patients who responded initially, subsequent follow-up studies showed no sustained control of hypercortisolism (therapeutic escape), which could result in lower long-term efficacy [223,224].…”

Section: Treatmentmentioning

confidence: 99%

Cushing’s Disease

Nishioka

Yamada²

2019

JCM

View full text Add to dashboard Cite

In patients with Cushing’s disease (CD), prompt diagnosis and treatment are essential for favorable long-term outcomes, although this remains a challenging task. The differential diagnosis of CD is still difficult in some patients, even with an organized stepwise diagnostic approach. Moreover, despite the use of high-resolution magnetic resonance imaging (MRI) combined with advanced fine sequences, some tumors remain invisible. Surgery, using various surgical approaches for safe maximum tumor removal, still remains the first-line treatment for most patients with CD. Persistent or recurrent CD after unsuccessful surgery requires further treatment, including repeat surgery, medical therapy, radiotherapy, or sometimes, bilateral adrenalectomy. These treatments have their own advantages and disadvantages. However, the most important thing is that this complex disease should be managed by a multidisciplinary team with collaborating experts. In addition, a personalized and individual-based approach is paramount to achieve high success rates while minimizing the occurrence of adverse events and improving the patients’ quality of life. Finally, the recent new insights into the pathophysiology of CD at the molecular level are highly anticipated to lead to the introduction of more accurate diagnostic tests and efficacious therapies for this devastating disease in the near future.

show abstract

Dopamine Agonists for Pituitary Adenomas

Cited by 37 publications

References 96 publications

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas

Postoperative Use of Dopamine Agonist in Controlling the Residual Mass in Non Functioning Pituitary Adenoma

Cushing’s Disease

Contact Info

Product

Resources

About