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Titolo:
SURGICAL INDICATION AFTER BROMOCRIPTINE THERAPY ON GIANT PROLACTINOMAS - EFFECTS AND LIMITATIONS OF THE MEDICAL-TREATMENT
Autore:
SAEKI N; NAKAMURA M; SUNAMI K; YAMAURA A;
Indirizzi:
CHIBA UNIV,SCH MED,DEPT NEUROL SURG,CHUO KU,1-8-1 INOHANA CHIBA 2600856 JAPAN KAWATETSU CHIBA HOSP CHIBA 2600842 JAPAN
Titolo Testata:
Endocrine journal
fascicolo: 4, volume: 45, anno: 1998,
pagine: 529 - 537
SICI:
0918-8959(1998)45:4<529:SIABTO>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOPAMINE AGONISTS; PITUITARY-TUMOR; RESISTANCE; MACROADENOMAS; GROWTH;
Keywords:
PROLACTINOMA; BROMOCRIPTINE; GIANT PITUITARY TUMOR; PITUITARY SURGERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
15
Recensione:
Indirizzi per estratti:
Citazione:
N. Saeki et al., "SURGICAL INDICATION AFTER BROMOCRIPTINE THERAPY ON GIANT PROLACTINOMAS - EFFECTS AND LIMITATIONS OF THE MEDICAL-TREATMENT", Endocrine journal, 45(4), 1998, pp. 529-537

Abstract

Bromocriptine (BC) is now an accepted primary therapeutic agent for patients with microadenoma. But, for patients with large or giant prolactinomas, the treatment choice is controversial. This report focuses on long-term results of the BC effect on 10 giant prolactinomas (maximum diameter more than 40 mm and the serum PRL level more than 1000 ng/ml) with particular emphasis on cases that needed surgical interventiondue to unsatisfactory results from BC therapy alone. BC was effectivein 6 cases (60%). They had the serum PRL level normalized in less than one year, with BC maintenance doses between 5-15 mg/day. MRI revealed complete or nearly total disappearance of the tumor. Discontinuationof the medicine was achieved in one patient. In the remaining 4 cases, surgery was needed for various reasons: 1) BC resistant prolactinomas in 2 cases, 2) large hematomas in one of the previous cases, 3) regrowth of tumor size, despite the nearly normalized PRL level due to bulk increase in non-secretory adenomatous portion in 1 case, and 4) intolerable side effect in 1 case. BC is effective even for giant prolactinomas in 60% of cases. But, this therapy needs surgical intervention more often than microadenomas. Surgical indications and timing should be decided on based on closer follow-up of neuroimaging and visual evaluation as well as the serum PRL level.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 06:57:40