Bromocriptine treatment of pituitary adenomas. Evaluation of withdrawal effect

Endocrinologie. 1983 Jul-Sep;21(3):157-68.

Abstract

Forty patients wtih pituitary adenomas, i.e. 22 prolactinomas, 13 acromegalies, 5 non-secreting adenomas, were submitted to bromocriptine therapy 19.3 +/- 1.7 mg/day (mean +/- SEM) (range 7.5-40.0 mg/day) for 5 to 41 months (10.1 +/- 1.31). Remission of the tumoral mass was documented by air tomograms (PETG) or computerized tomograms (CT) in all but one prolactinomas and in 2 mixed HGH and PRL-secreting adenomas. Six empty sella syndromes (ESS) were produced, 4 of them during primary chemotherapy. Serum PRL decreased to normal in all but 3 prolactinomas, and serum HGH levels in 5 out of 13 acromegalies. Bromocriptine withdrawal was followed by a rapid increase of serum PRL into the pathological range, without a rapid reexpansion of the tumoral remnants: GT or surgical exploration of 4 cases, remitted until ESS showed a minimal evolution along 8 months after bromocriptine withdrawal. It is suggested that the antitumoral effect of bromocriptine is specific to lactotrophic cells and at least partially irreversible.

MeSH terms

  • Acromegaly / drug therapy*
  • Adenoma / drug therapy*
  • Adult
  • Bromocriptine / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / drug therapy*
  • Pituitary Neoplasms / metabolism
  • Pneumoencephalography
  • Prolactin / metabolism*
  • Substance Withdrawal Syndrome
  • Tomography, X-Ray Computed

Substances

  • Bromocriptine
  • Prolactin