[Results of bromocriptine treatment of giant or invasive prolactin adenomas. Apropos of 20 cases].
The therapeutic results of twenty patients with giant expansive prolactinomas were studied under bromocriptine as treatment of first intent (Group I, n = 10) or of second intent after surgery with or without radiotherapy (Group II, n = 10). Patients in Group I (PRL: 350-17 000 ng/ml) were given bromocriptine alone (10 to 20 mg/day) for a period of 21 days to 22 months. The visual fields and acuity returned to normal in 8 days to 3 months in 4 out of 7 patients and significantly improved in 2 out of 7 patients. A reduction in tumour size was demonstrated on CT scanning in 7 out of 10 patients mainly in the suprasellar region (6/9) with appearances of a partially empty sella in 4 cases. Normalisation of the PRL (7 out of 10 cases) was accompanied by a correction of one or more other hypophyseal deficits in 3 patients. Bromocriptine was continued in 5 out of 10 cases with a good result after 12 to 22 months follow-up. Five patients were referred secondarily for surgery for spontaneous rhinorrhea in 1 patient or because Bromocriptine was only partially effective in 4 patients; a postoperative visual improvement with reduced serum prolactin levels was observed in these 4 cases. In Group II (PRL: 200-11 600 ng/ml after surgery), bromocriptine therapy (5 to 30 mg/day for 1.5 to 72 months) was associated with normalisation or a significant improvement in visual symptoms in 6 out of 9 cases and a reduction in tumour size in 8 out of 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
D000236:Adenoma / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D000293:Adolescent; D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D011388:Prolactin / Q000378:metabolism*; D013997:Time Factors
D001971:Bromocriptine; D011388:Prolactin
Résultats du traitement par Bromocriptine des adénomes à prolactine géants ou expansifs. A propos de 20 observations.