Visual failure from pituitary and parasellar tumours occurring with favourable outcome in pregnant women.

Falconer, M; Stafford-Bell, Martyn

doi:10.1136/jnnp.38.9.919

Cited by 32 publications

(4 citation statements)

References 10 publications

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“…Reports of enlargement of prolactinomas associated with pregnancy began over 30 yr ago, shortly after the introduction of bromocriptine as an effective medical therapy for these tumors (334,(361)(362)(363)(364)(365)(366)(367)(368)(369). Early on, many of the symptomatic patients underwent surgery for visual defects (334,363,365,367). However, the observation was soon made that in those who were managed without surgery, symptoms resolved shortly after parturition (334,364,366,368).…”

Section: A Effect Of Pregnancy On Prolactinoma Growthmentioning

confidence: 93%

“…After delivery, the gland rapidly involutes and returns to its normal size by 6 months postpartum (358,359). Reports of enlargement of prolactinomas associated with pregnancy began over 30 yr ago, shortly after the introduction of bromocriptine as an effective medical therapy for these tumors (334,(361)(362)(363)(364)(365)(366)(367)(368)(369). Early on, many of the symptomatic patients underwent surgery for visual defects (334,363,365,367).…”

Section: A Effect Of Pregnancy On Prolactinoma Growthmentioning

confidence: 97%

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Advances in the Treatment of Prolactinomas

et al. 2006

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Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future.

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Section: A Effect Of Pregnancy On Prolactinoma Growthmentioning

confidence: 93%

Section: A Effect Of Pregnancy On Prolactinoma Growthmentioning

confidence: 97%

Advances in the Treatment of Prolactinomas

et al. 2006

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“…The other is whether neurosurgical treatment should be carried out before labor. Some neurosurgeons recommend surgical decompression of the optic nerve whenever vision is seriously threatened (Enoksson et al, 1961;Falconer & Stafford-Bell, 1975). In our patient visual acuity of the left eye was seriously impaired after 31 weeks' gestation.…”

Section: Discussionmentioning

confidence: 69%

Visual evoked potential in the management of pituitary tumor during pregnancy

Mashima

Oguchi

1987

Doc Ophthalmol

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We examined a pregnant woman with chiasmal syndrome in the late stage of pregnancy. Her vision was determined to be seriously threatened after 31 weeks' gestation. Study of the latency of preoperative visual evoked potentials (VEPs) in other patients with pituitary tumor showed that insofar as latency is not delayed, surgical decompression is expected to be followed by functional improvement of the optic pathway. We monitored optic nerve function by serially recorded VEPs, and labor was induced at 38 weeks because there had been no delayed response up to that time. After a decompressive operation, visual field and visual acuity recovered normally. Serially recorded VEPs can provide a useful monitor along with visual field and acuity tests in guiding therapy for a patient with threatened vision in late pregnancy and in determining whether or when to induce labor.

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“…If a living child is not possible at that time treatment by the neurosurgeon is indicated.' Falconer and Stafford-Bell (1975) stated that the treatment of choice whenever vision is seriously threatened at any stage of pregnancy is a surgical attack on the pituitary, followed by suitable replacement therapy to ensure that the pregnancy continues.…”

Section: Discussionmentioning

confidence: 99%

Rapid deterioration of visual fields during bromocriptine-induced pregnancy in a patient with a pituitary adenoma.

Dalen¹,

Greve²

1977

British Journal of Ophthalmology

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Kajtar and Tomkin (1971). In subsequent (induced) pregnancies visual field defects developed, leading to termination of the pregnancy in the 39th week in one case (Corbey), spontaneous regression of the defects after the 36th week of pregnancy (Lamberts), and performance of hypophysectomy in a third patient (Kajtar and Tomkin). In this third case there was gross erosion ofthe posterior clinoids, and a pituitary adenoma was found.Case history A woman, now aged 25 years, was first seen in our ophthalmology department in July 1975, having been referred to us by the gynaecologist. After a period on oral contraceptives (1970-2) she had developed oligomenorrhoea and galactorrhoea, followed in 1973 by amenorrhoea. In July 1975 high prolactin levels were found (87 ng/ml; normal value 20 ng/ml), and it was concluded that this patient had a pro-

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Visual failure from pituitary and parasellar tumours occurring with favourable outcome in pregnant women.

Cited by 32 publications

References 10 publications

Advances in the Treatment of Prolactinomas

Advances in the Treatment of Prolactinomas

Visual evoked potential in the management of pituitary tumor during pregnancy

Rapid deterioration of visual fields during bromocriptine-induced pregnancy in a patient with a pituitary adenoma.

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