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

Abstract

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)

Gonadotroph pituitary macroadenoma inducing ovarian hyperstimulation syndrome: successful response to octreotide therapy

“…Dopamine agonists such as bromocriptine and cabergoline have proven to be effective in reducing estradiol levels and decreasing ovarian size, 7,8 but tumor reduction very occasionally occurs, usually under high doses of bromocriptine. 9 GnRH analogs are not effective and may induce a paradoxical increase in gonadotropin secretion, 7,10 leading to deterioration of OHSS.…”

Ovarian hyperstimulation syndrome caused by an FSH-secreting pituitary adenoma

“…In theory, one possible medical treatment would be the administration of a GnRH analog which would decrease FSH levels, thereby leading to resolution of OHSS; however, reports have actually shown a paradoxical increase in gonadotropin secretion in response to this treatment, 4,[15][16][17][18][19][20] and in one case OHSS was induced after initiation of GnRH therapy with dramatic increases in FSH and estradiol levels. 21 There are three reports of patients with OHSS who were initially treated medically.…”