Prolactinomas and optic nerve compression: disappearance of suprasellar extension and visual recovery after two weeks bromocriptine treatment.
4 patients with prolactinomas and visual field defects are presented. 2 were treated with bromocriptine alone; 1 patient with an 8-month history of visual disturbance had complete recovery of visual fields after 2 weeks and an acute fall in serum prolactin levels. This coincided with disappearance of the suprasellar extension on computer tomography (CT) scanning. The second patient, with a 2-year history, had no visual improvement after 1 year of treatment, although CT scanning showed absence of the suprasellar extension when repeated after 3 months. 2 other patients initially had neurosurgery; 1 with a 2-year history had complete visual recovery, the other with a 1-year history did not recover. Both needed subsequent bromocriptine treatment. In all 4 patients this drug produced a sustained fall in serum prolactin levels. We conclude that bromocriptine therapy can rapidly reduce prolactinoma tumor size and should obviate the necessity for acute neurosurgical intervention in carefully selected patients.
D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D011877:Radionuclide Imaging; D014786:Vision Disorders / Q000209:etiology*
D001971:Bromocriptine; D011388:Prolactin