GIANT PROLACTINOMA AND EFFECTIVENESS OF MEDICAL MANAGEMENT

Objective: To review our experience with long-term caberooline and brorriocriptine therapy in the treatment of grant pralactinomas Methods: Patients with giant prolactinoinas chao- C, nosed and tre ited It Our center ill Wmbai, India. between January 2005 and January 2009 were included Diagnostic criteria for giant prolactinomi included tumor diameter greater than 40 mm, serum prolactin concentration higher, than 1000 ng/mL and invasive tumor growth pattern with mass effects Cabergoline was started at a dosae of 0.5 mg weekly and pro-ressivelv increased as necessary up to 3 5 weekly Patients were followed up With hormone measurements. sellar magnetic resonance imaging. and vision examinations Results: The study group included 10 patients (5 male and 5 f'cmale). aged 17 to 50 years (mean. 36.1 years), treated for giant prolactillollia In 8, Patients. cabergollile was first-line therapy Two patients had prevlously been prescribed bromocriptine, and this, regimen was maintained Mean serum prolactine concentration before treatment was 10 789 +/- 14 278 m/ml (range. 1256-43 +/- 163 nL/mL: reference range, 5-17 n-/mL) Following, treatment. levels normalized ill 7 patients within 2 to IS months (mean, 8 8 months) mid decreased ill I patient to level 3 to 4 times that of' normal 'I'Llmor diameter. which measured from 4 to 7 cm at dia-nosis-showed a mean maximal decrease of 49 28 +/- 18.27%, response was first noted about 6 montlis after treitment was be will Seven patients had visual field defects at diaonosis: vision returned to normal in 3 and improved ill 4 Testosteroile levels, Initially low ill in male patients. normalized ill 3 Conclusion: Caber-oline Should be first-line therapy for acogressive prolactinomas. even ill those patients who present with visual field defects (Enclocr Pract. 2010; 16:42-46)