Follicle-stimulating hormone- and alpha-subunit-secreting pituitary tumor treated with bromocriptine.
Glycoprotein-secreting pituitary tumors are uncommon. With increased awareness that pituitary tumors may secrete FSH, LH, TSH, and the alpha-subunit, either as a sole product or in any combination, these tumors are more likely to be recognized. The standard therapy is surgical resection and, possibly, postoperative radiotherapy for residual tumor mass or persistent hormonal secretion. We report a patient with a FSH- and alpha-subunit-secreting tumor who refused surgery and was treated with the dopamine agonist bromocriptine as primary therapy. Bromocriptine treatment resulted in reduction of serum FSH and alpha-subunit levels to normal, improvement of visual field defects, and improvement in hypogonadism despite lack of demonstrable change in tumor size, as assessed by computed tomographic scan. Chromatographic analysis of the serum revealed distinct peaks corresponding to those of labeled FSH and alpha-subunit. The clinical and biochemical responses in this patient suggest that some glycoprotein-secreting tumors may be responsive to dopamine agonist therapy.
M L
ML
Vance
E C
EC
Ridgway
M O
MO
Thorner
D000236:Adenoma / Q000188:drug therapy / Q000378:metabolism; D001971:Bromocriptine / Q000627:therapeutic use*; D002850:Chromatography, Gel; D005640:Follicle Stimulating Hormone / Q000097:blood*; D015292:Glycoprotein Hormones, alpha Subunit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D010908:Pituitary Hormones, Anterior / Q000097:blood*; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000378:metabolism*; D011388:Prolactin / Q000097:blood; D011863:Radioimmunoassay; D013972:Thyrotropin / Q000097:blood; D014794:Visual Fields
D015292:Glycoprotein Hormones, alpha Subunit; D010446:Peptide Fragments; D010908:Pituitary Hormones, Anterior; D001971:Bromocriptine; D011388:Prolactin; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin