Remarkable effects of cabergoline in a patient with huge prolactinoma resistant to high-dose bromocriptine: case report.

Abstract

BACKGROUND:

Cabergoline (CAB) has been proposed as the first-line treatment in the management of prolactin (PRL)-secreting tumors (prolactinoma [PRLoma]), including those resistant to standard dopamine agonist (DAA) therapy. The authors report remarkable effects of CAB in a case of huge PRLoma that had been resistant to a long-term, high-dose treatment with bromocriptine (BRC).

CASE DESCRIPTION:

A 28-year-old man was originally presented with oculomotor paresis when he was 9 years old. After 2 partial resections, he was treated with a maximum 60-mg/d dose of BRC for 18 years. Nonetheless, the tumor grew up to more than 8 cm in diameter, serum PRL increased over 60000 ng/mL, and his visual acuity deteriorated. Cabergoline normalized serum PRL level, shrank the tumor mass remarkably, and caused marked improvement of visual acuity.

CONCLUSION:

Prolactin normalization and significant tumor shrinkage could be achieved with CAB even in extremely BRC-resistant PRLomas. Surgical resection should be reserved only for patients who are resistant to cabergoline or who require urgent decompression in such emergency as massive intratumoral hemorrhage.

• Authors: Yasuhiro Kawabata, Yasushi Ueno, Fumihiko Horikawa, Hidenori Miyake, Nobuhiro Miki, Masami Ono
• Journal: Surgical neurology (Surg Neurol) Vol. 69 Issue 1 Pg. 85-8; discussion 88 (Jan 2008) ISSN: 0090-3019 [Print] United States
• PMID: 17967478 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Dopamine Agonists
• Ergolines
• Bromocriptine
• Cabergoline

Topics

• Adult
• Antineoplastic Agents (therapeutic use)
• Bromocriptine (therapeutic use)
• Cabergoline
• Dopamine Agonists (therapeutic use)
• Drug Resistance, Neoplasm
• Ergolines (therapeutic use)
• Humans
• Male
• Pituitary Neoplasms (drug therapy, pathology)
• Prolactinoma (drug therapy, pathology)
• Treatment Outcome