Keywords
cabergoline
dopamine agonists
How to Cite
Abstract
The non-functioning pituitary adenomas (NFPA) are not accompanied by any manifestation of hormonal hypersecretion. Their symptoms are due to the compressive effect of tumor growth, being transsphenoidal surgery the treatment of choice as initial therapy, while in those in which there are not symptoms, expectant management is suggested. At the moment, there is not standardized pharmacological treatment for the management of NFPA. However, the use of dopamine agonists to reduce the size of NFPA has been postulated. It is presented the case of a patient with an incidental finding of NFPA in contact with the optic chiasm, without clinical manifestations, who rejected the surgical intervention, for which a therapeutic trial with cabergoline was performed. After six months of treatment a magnetic resonance was performed and evidence of tumor volume reduction of 73 % was observed without contact with the chiasm.
References
2. Al-Dahmani K, Mohammad S, Imran F, Theriault C, Doucette S, Zwicker D, et al. Sellar Masses: An Epidemiological Study. Can J Neurol Sci. 2016;43(2):291-7.
3. Tampourlou M, Karapanou O, Vassiliadi DA, Tsagarakis S. Medical therapy for non-functioning pituitary tumors-a critical approach. Hormones (Athens). 2019;18(2):117-26.
4. J Snyder, MD, P. (2019, 22 marzo). Incidentally discovered sellar masses (pituitary incidentalomas). UpToDate. Waltham, MA: UpToDate Inc.
https://www.uptodate.com (Consultado en julio 02, 2019.)
5. Colao A, Di Somma C, Pivonello R, Faggiano A, Lombardi G, Savastano S. Medical therapy for clinically non-functioning pituitary adenomas. Endocr Relat Cancer. 2008;15(4):905-15.
6. Galland F, Vantyghem MC, Cazabat L, Boulin A, Cotton F, Bonneville JF, et al. Consensus Management of nonfunctioning pituitary incidentaloma. Annales d’Endocrinologie. 2015;76:191-200.
7. Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, et al. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(4):894-904.
8. Dekkers OM, Hammer S, de Keizer RJ, Roelfsema F, Schutte PJ, Smit JW, et al. The natural course of non-functioning pituitary macroadenomas. Eur J Endocrinol. 2007;156(2):217-24.
9. Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S. Management of clinically non-functioning pituitary adenoma. Annales d’Endocrinologie 2015;76:239-47.
10. Greenman Y, Cooper O, Yaish I, Robenshtok E, Sagiv N, Jonas-Kimchi T, et al. Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists. Eur J Endocrinol. 2016;175(1):63-72.
11. Henao DC, Rojas W. Manejo de pacientes con diagnóstico de adenoma hipofisario productor de prolactina. Experiencia del Hospital San José. Revista Colombiana de Endocrinología, Diabetes & Metabolismo. 2017;1(1):20-6.
12. Colao A, Di Somma C, Pivonello R, Faggiano A, Lombardi G, Savastano S. Medical therapy for clinically non-functioning pituitary adenomas. Endocr Relat Cancer. 2008;15(4):905-15.
13. Garcia EC, Naves LA, Silva AO, de Castro LF, Casulari LA, Azevedo MF. Shortterm treatment with cabergoline can lead to tumor shrinkage in patients with nonfunctioning pituitary adenomas. Pituitary. 2013;16(2):189-94.
14. Vieira Neto L, Wildemberg LE, Moraes AB, Colli LM, Kasuki L, Marques NV, et al. Dopamine receptor subtype 2 expression profile in nonfunctioning pituitary adenomas and in vivo response to cabergoline therapy. Clin Endocrinol (Oxf). 2015;82(5):739-46.
15. de Herder WW, Reijs AE, Feelders RA, van Aken MO, Krenning EP, Tanghe HL, et al. Dopamine agonist therapy of clinically non-functioning pituitary macroadenomas. Is there a role for 123I-epidepride dopamine D2 receptor imaging? Eur J Endocrinol. 2006;155(5):717-23.
16. Pivonello R, Matrone C, Filippella M, Cavallo LM, Di Somma C, Cappabianca P, et al. Dopamine receptor expression and function in clinically nonfunctioning pituitary tumors: comparison with the effectiveness of cabergoline treatment. J Clin Endocrinol Metab. 2004;89(4):1674-83.
Authors must state that they reviewed, validated and approved the manuscript's publication. Moreover, they must sign a model release that should be sent. A copy may be reviewed here