Intracranial dissemination of a macroprolactinoma.
A patient with a macroprolactinoma and extrasellar extension was treated by incomplete transfrontal surgery, external irradiation and additional bromocriptine (Br) treatment. After 4 years, partial bromocriptine resistance developed (a rare occurrence) together with the appearance of intracranial metastases. 123I-Iodobenzamide was helpful in evaluating the dopamine D2 receptor status of the metastatic tumour both in vivo using single-photon emission computed tomography (SPECT) and in vitro. Prolactin release by the cultured metastatic tumour cells was more potently inhibited by CV 205-502 than by bromocriptine. The patient, treated by surgery, irradiation and CV 205-502, developed a ptosis of the left eye and a transient psychiatric delusional state, the latter probably an effect of the dopamine agonist. As the right frontal metastasis was markedly positive on SPECT with 111In-SMS, somatostatin treatment was added to the CV 205-502.
Assies
J
J
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands.
Verhoeff
N P
NP
Bosch
D A
DA
Hofland
L J
LJ
D000634:Aminoquinolines / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary*; D001971:Bromocriptine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000628:therapy*; D015175:Prolactinoma / Q000628:therapy*; D011879:Radiotherapy Dosage; D013004:Somatostatin / Q000627:therapeutic use
D000634:Aminoquinolines; D001971:Bromocriptine; D013004:Somatostatin; C046650:quinagolide