ACTH silent adenoma shrinking under cabergoline.
OBJECTIVE
The authors present a case report that proposes the use of cabergoline treatment in silent ACTH adenoma, an unusual member of the heterogeneous group of the so-called clinically non-functioning pituitary adenomas.


METHODS
Following the clinical and radiological improvement of a recurrent silent ACTH adenoma in a 77-year-old patient treated with cabergoline (0.5 mg every 2 days for 2 years), in vitro studies of the original tumor were performed.


METHODS
The original tumor from the patient was studied by in situ hybridization and dopamine D2 receptor autoradiography. It was compared with four macroprolactinomas and two macroadenomas from patients with Cushing's disease.


RESULTS
The D2 receptor mRNA signal of the reported case was intense and of the same order of magnitude as that observed in control prolactinomas. Dopamine D2 receptor autoradiography was twice that of control corticotroph adenomas and was close to that observed in prolactinomas.


CONCLUSIONS
This is the first description of an in vivo shrinkage of an ACTH silent adenoma under cabergoline. We demonstrate in vitro, the presence of D2 receptors in the primitive tumor in concentrations similar to those found in control prolactinomas. These results suggest that therapeutic trials with cabergoline might be undertaken in recurring cases of ACTH silent tumors and more generally, non-functioning pituitary adenomas.
Petrossians
P
P
Endocrinology, CHU Sart Tilman, Liège, Belgium.
Ronci
N
N
Valdés Socin
H
H
Kalife
A
A
Stevenaert
A
A
Bloch
B
B
Tabarin
A
A
Beckers
A
A
D000236:Adenoma / Q000737:chemistry / Q000188:drug therapy* / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001345:Autoradiography; D000077465:Cabergoline; D004873:Ergolines / Q000627:therapeutic use*; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000378:metabolism; D015175:Prolactinoma / Q000737:chemistry; D012333:RNA, Messenger / Q000032:analysis; D017448:Receptors, Dopamine D2 / Q000032:analysis / Q000235:genetics
D000970:Antineoplastic Agents; D004873:Ergolines; D012333:RNA, Messenger; D017448:Receptors, Dopamine D2; D000324:Adrenocorticotropic Hormone; D000077465:Cabergoline