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

Abstract

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%)

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

“…In agreement with our findings, the study of Mahmoud et al, [19] reported that 32-cases were involved in this work. 21-cases (66%) were women and 11-cases (34%) were men.…”

“…D2R and estrogen receptors [ER a (ESR1)] and ERP (ESR2) had been immuno-stained, digitalized, and counted on the Cedars-Sinai Translational Research Core in 53 tumour specimens of DAmanaged cases. The percent of positive cells and staining intensities was recorded for all slides via the immuno-reactivity score system (IRS) [15] and the (QUICK-Score) method [19] .…”