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January 15, 1982, Vol 247, No. 3 >
ARTICLE | January 15, 1982

Bromocriptine Reduces Pituitary Tumor Size and Hypersecretion: Title and subTitle BreakRequiem for Pituitary Surgery? FREE

Richard F. Spark, MD; Richard Baker, MD; Don C. Bienfang, MD; Richard Bergland, MD
[+] Author Affiliations

Presented in part at the 50th annual meeting of the American Association of Neurologic Surgeons, Boston, April 7, 1981.

Reprint requests to the Steroid Research Laboratory, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215 (Dr Spark).


JAMA. 1982;247(3):311-316. doi:10.1001/jama.1982.03320280031025
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References

Twelve patients with pituitary tumor whose prior treatment included surgery and radiotherapy in four, surgery alone in four, radiotherapy alone in one, and none in three were studied. Nine had hyperprolactinemia, two had elevated serum growth hormones, and one had no pituitary hormone excess. Visual field defects were present in six. All had pituitary-gonadal insufficiency manifested as impotence or amenorrhea. All were treated with bromocriptine, 7.5 to 25 mg daily, and followed up for eight to 27 ([unk] 15) months. Serum prolactin levels decreased to normal in seven of nine patients. Serum growth hormone values were normalized in both acromegalics. When hormone levels were reduced to normal, pituitary tumor size decreased. Vision was restored to normal in five of six patients, including one patient with pituitary tumor but no pituitary hormone excess. Bromocriptine corrects the physiological defects associated with pituitary tumors that have been incompletely treated with surgery, radiotherapy, or both and may be a useful primary treatment for patients with pituitary tumors.

(JAMA 1982;247:311-316)

REFERENCES

1 +
Besser GM, Parke L, Edwards CRW, et al:  Galactorrhea: Successful treatment with reduction of plasma prolactin levels by bromergocryptine . Br Med J 1972;;3:669-672.
2 +
Spark RF, Dickstein G, Pallotta J:  Complete remission of acromegaly with medical treatment . JAMA 1979;;241:573-575.
3 +
McGregor AM, Scanlon MF, Hall K, et al:  Reduction in size of a pituitary tumour by bromocriptine therapy . N Engl J Med 1979;; 300:291-293.
4 +
Landolt AM, Wüthrich R, Fellmann H:  Regression of pituitary prolactinoma after treatment with bromocriptine . Lancet 1979;;1:1082-1083.
5 +
Thorner MO, Martin WH, Rogol AD, et al:  Rapid regression of pituitary prolactinomas during bromocriptine treatment . J Clin Endocrinol Metab 1980;;51:438-445.
6 +
Spark RF:  Simplified assessment of pituitary-adrenal reserve: Measurement of plasma 11-deoxycortisol and cortisol after metyrapone . Ann Intern Med 1971;;75:717-723.
7 +
Connolly P, White R, Dickstein G, et al:  Measurement of simultaneous plasma ACTH and 11-deoxycortisol levels enhance diagnostic accuracy of metyrapone testing , abstracted. Clin Res 1979;;2:572.
8 +
Foley TP, Owings J, Hayford JT, et al:  Serum thyrotropin responses to synthetic thyrotropin-releasing hormone in normal children and hypopituitary patients: A new test to distinguish primary releasing hormone deficiency from primary pituitary hormone deficiency . J Clin Invest 1972;;51:431.
9 +
Chen J, Zorn E, Halbert M, et al:  Antibodies to testosterone-3 bovine serum albumin applied to assay of serum 17-beta-olandrogens . Clin Chem 1971;;17:581-584.
10 +
Odell ND, Ross GT, Rayford PL:  Radioimmunoassay for luteinizing hormone in human plasma or serum . J Clin Invest 1967;;46:248-255.
11 +
Sinha NN, Selby FW, Lewis UJ, et al:  A homologous radioimmunoassay for human prolactin . J Clin Endocrinol Metab 1973;;36:509-516.
12 +
Schalch DS, Parker ML:  A sensitive double antibody immunoassay for human growth hormone in plasma . Nature 1964;;203:1141.
13 +
Post KD, Biller BJ, Adelman LS, et al:  Selective transsphenoidal adenomectomy in women with galactorrhea-amenorrhea . JAMA 1979;;242:158-162.
14 +
Tucker HStG, Grubb SR, Wigand JP, et al:  Galactorrhea-amenorrhea syndrome: Follow-up of 45 patients after pituitary tumor removal . Ann Intern Med 1981;;94:302-307.
15 +
Hardy J:  Transsphenoidal surgery of hypersecreting pituitary tumors , in Kohler PQ, Ross GT (eds): Diagnosis and Treatment of Pituitary Tumors . New York, American Elsevier, 1973;, pp 179-194.
16 +
Werder KV, Fahlbusch R, Landgraf R, et al:  Treatment of patients with prolactinomas . J Endocrinol Invest 1978;;1:47-59.
17 +
Antunes JL, Housepian EM, Frantz AG, et al:  Prolactin-secreting pituitary tumors . Ann Neurol 1977;;2:148.
18 +
Gomez F, Reyes FI, Faiman C:  Nonpuerperal galactorrhea and hyperprolactinemia . Am J Med 1977;;62:648.
19 +
Kjellberg R, Kliman B:  Radiosurgery therapy for pituitary adenoma , in Post K, Jackson I, Reichlin S (eds): The Pituitary Adenoma . New York, Plenum Publishing Corp, 1980;, pp 459-478.
20 +
Seki K, Seki M, Okamura T:  Effect of CB-154 (2-Br-a-ergo-cryptine) on serum follicle stimulating hormone, luteinizing hormone, and prolactin in women with the amenorrhea-galactorrhea syndrome . Acta Endocrinol 1975;;79:25.
21 +
Spark RF, Pallotta J, Naftolin F:  Galactorrhea-amenorrhea syndromes: Etiology and treatment . Ann Intern Med 1976;;84:532.
22 +
Fossati P, Strauch G, Tourniaire J:  Etude de l'activite de la bromocriptine dans les etats d'hyperprolactinemie: Resultats d'un essai cooperatif chez 135 patients . Nouv Presse Med 1976;;5:1687.
23 +
Friesen HG, Tolis G:  The use of bromocriptine in the galactorrhea-amenorrhea syndromes: The Canadian Cooperative Study . Clin Endocrinol 1977;;6( (suppl) ):91.
24 +
Carter JN, Tyson JE, Tolis G, et al:  Prolactin-secreting tumors and hypogonadism in 22 men . N Engl J Med 1978;;299:847-852.
25 +
Wass JAH, Thorner MO, Morris DV, et al:  Long-term treatment of acromegaly with bromocriptine . Br Med J 1977;;1:875.
26 +
Wass JAH, Thorner MO, Charlesworth M, et al:  Reduction of pituitary tumour size in patients with prolactinomas and acromegaly treated with bromocriptine with or without radiotherapy . Lancet 1979;;2:66-69.
27 +
Lindholm J, Riishede J, Vestergaood S, et al:  No effect of bromocriptine in acromegaly: A controlled trial . N Engl J Med 1981;;304:1450-1454.
28 +
MacLeod RM, Lehmeyer JE:  Suppression of pituitary tumor growth and function by ergot alkaloids . Cancer Res 1973;;33:849.
29 +
Lloyd HM, Meares JD, Jacobi J:  Effects of oestrogen and bromocryptine on in vivo secretion and mitosis in prolactin cells . Nature 1975;; 255:497.
30 +
Ourednik J, May P, Mittler J, et al:  Bromocriptine blocks estrogen induced pituitary growth and hyperprolactinemia , abstracted. Clin Res 1979;;27:575.
31 +
Hockfelt T, Fuxe K:  On the morphology and neuroendocrine role of the hypothalamic catecholamine neurons , in Knigge KM, Scott DE, Weindel A (eds): Brain Endocrine Interaction: Structure and Function . Basel, Switzerland, S Karger AG, 1972;, pp 181-223.
32 +
Tucker HStG, Lankford HV, Glackard WG:  Persistent defect in regulation of prolactin secretion following successful pituitary tumor removal in women with galactorrhea-amenorrhea syndrome . J Clin Endocrinol Metab 1980;; 51:968-971.
33 +
Pasteels JL, Danguy A, Ectors F:  Inhibition de secretion de prolactine par l'ergocornine et la 2-br-alpha-ergo-kryptine: Action directe sur L-hypophyse en culture . Ann Endocrinol 1971;;32:188-198.
34 +
Hockfelt R, Ruxe K:  Effects of prolactin and ergot alkaloids on the tuberoinfundibular dopamine (DA) neurons . Neuroendocrinology 1972;;9:100-122.
35 +
Cushing H: Studies in Intracranial Physiology and Surgery . London, Oxford University Press, 1926;.

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1 +
Besser GM, Parke L, Edwards CRW, et al:  Galactorrhea: Successful treatment with reduction of plasma prolactin levels by bromergocryptine . Br Med J 1972;;3:669-672.
2 +
Spark RF, Dickstein G, Pallotta J:  Complete remission of acromegaly with medical treatment . JAMA 1979;;241:573-575.
3 +
McGregor AM, Scanlon MF, Hall K, et al:  Reduction in size of a pituitary tumour by bromocriptine therapy . N Engl J Med 1979;; 300:291-293.
4 +
Landolt AM, Wüthrich R, Fellmann H:  Regression of pituitary prolactinoma after treatment with bromocriptine . Lancet 1979;;1:1082-1083.
5 +
Thorner MO, Martin WH, Rogol AD, et al:  Rapid regression of pituitary prolactinomas during bromocriptine treatment . J Clin Endocrinol Metab 1980;;51:438-445.
6 +
Spark RF:  Simplified assessment of pituitary-adrenal reserve: Measurement of plasma 11-deoxycortisol and cortisol after metyrapone . Ann Intern Med 1971;;75:717-723.
7 +
Connolly P, White R, Dickstein G, et al:  Measurement of simultaneous plasma ACTH and 11-deoxycortisol levels enhance diagnostic accuracy of metyrapone testing , abstracted. Clin Res 1979;;2:572.
8 +
Foley TP, Owings J, Hayford JT, et al:  Serum thyrotropin responses to synthetic thyrotropin-releasing hormone in normal children and hypopituitary patients: A new test to distinguish primary releasing hormone deficiency from primary pituitary hormone deficiency . J Clin Invest 1972;;51:431.
9 +
Chen J, Zorn E, Halbert M, et al:  Antibodies to testosterone-3 bovine serum albumin applied to assay of serum 17-beta-olandrogens . Clin Chem 1971;;17:581-584.
10 +
Odell ND, Ross GT, Rayford PL:  Radioimmunoassay for luteinizing hormone in human plasma or serum . J Clin Invest 1967;;46:248-255.
11 +
Sinha NN, Selby FW, Lewis UJ, et al:  A homologous radioimmunoassay for human prolactin . J Clin Endocrinol Metab 1973;;36:509-516.
12 +
Schalch DS, Parker ML:  A sensitive double antibody immunoassay for human growth hormone in plasma . Nature 1964;;203:1141.
13 +
Post KD, Biller BJ, Adelman LS, et al:  Selective transsphenoidal adenomectomy in women with galactorrhea-amenorrhea . JAMA 1979;;242:158-162.
14 +
Tucker HStG, Grubb SR, Wigand JP, et al:  Galactorrhea-amenorrhea syndrome: Follow-up of 45 patients after pituitary tumor removal . Ann Intern Med 1981;;94:302-307.
15 +
Hardy J:  Transsphenoidal surgery of hypersecreting pituitary tumors , in Kohler PQ, Ross GT (eds): Diagnosis and Treatment of Pituitary Tumors . New York, American Elsevier, 1973;, pp 179-194.
16 +
Werder KV, Fahlbusch R, Landgraf R, et al:  Treatment of patients with prolactinomas . J Endocrinol Invest 1978;;1:47-59.
17 +
Antunes JL, Housepian EM, Frantz AG, et al:  Prolactin-secreting pituitary tumors . Ann Neurol 1977;;2:148.
18 +
Gomez F, Reyes FI, Faiman C:  Nonpuerperal galactorrhea and hyperprolactinemia . Am J Med 1977;;62:648.
19 +
Kjellberg R, Kliman B:  Radiosurgery therapy for pituitary adenoma , in Post K, Jackson I, Reichlin S (eds): The Pituitary Adenoma . New York, Plenum Publishing Corp, 1980;, pp 459-478.
20 +
Seki K, Seki M, Okamura T:  Effect of CB-154 (2-Br-a-ergo-cryptine) on serum follicle stimulating hormone, luteinizing hormone, and prolactin in women with the amenorrhea-galactorrhea syndrome . Acta Endocrinol 1975;;79:25.
21 +
Spark RF, Pallotta J, Naftolin F:  Galactorrhea-amenorrhea syndromes: Etiology and treatment . Ann Intern Med 1976;;84:532.
22 +
Fossati P, Strauch G, Tourniaire J:  Etude de l'activite de la bromocriptine dans les etats d'hyperprolactinemie: Resultats d'un essai cooperatif chez 135 patients . Nouv Presse Med 1976;;5:1687.
23 +
Friesen HG, Tolis G:  The use of bromocriptine in the galactorrhea-amenorrhea syndromes: The Canadian Cooperative Study . Clin Endocrinol 1977;;6( (suppl) ):91.
24 +
Carter JN, Tyson JE, Tolis G, et al:  Prolactin-secreting tumors and hypogonadism in 22 men . N Engl J Med 1978;;299:847-852.
25 +
Wass JAH, Thorner MO, Morris DV, et al:  Long-term treatment of acromegaly with bromocriptine . Br Med J 1977;;1:875.
26 +
Wass JAH, Thorner MO, Charlesworth M, et al:  Reduction of pituitary tumour size in patients with prolactinomas and acromegaly treated with bromocriptine with or without radiotherapy . Lancet 1979;;2:66-69.
27 +
Lindholm J, Riishede J, Vestergaood S, et al:  No effect of bromocriptine in acromegaly: A controlled trial . N Engl J Med 1981;;304:1450-1454.
28 +
MacLeod RM, Lehmeyer JE:  Suppression of pituitary tumor growth and function by ergot alkaloids . Cancer Res 1973;;33:849.
29 +
Lloyd HM, Meares JD, Jacobi J:  Effects of oestrogen and bromocryptine on in vivo secretion and mitosis in prolactin cells . Nature 1975;; 255:497.
30 +
Ourednik J, May P, Mittler J, et al:  Bromocriptine blocks estrogen induced pituitary growth and hyperprolactinemia , abstracted. Clin Res 1979;;27:575.
31 +
Hockfelt T, Fuxe K:  On the morphology and neuroendocrine role of the hypothalamic catecholamine neurons , in Knigge KM, Scott DE, Weindel A (eds): Brain Endocrine Interaction: Structure and Function . Basel, Switzerland, S Karger AG, 1972;, pp 181-223.
32 +
Tucker HStG, Lankford HV, Glackard WG:  Persistent defect in regulation of prolactin secretion following successful pituitary tumor removal in women with galactorrhea-amenorrhea syndrome . J Clin Endocrinol Metab 1980;; 51:968-971.
33 +
Pasteels JL, Danguy A, Ectors F:  Inhibition de secretion de prolactine par l'ergocornine et la 2-br-alpha-ergo-kryptine: Action directe sur L-hypophyse en culture . Ann Endocrinol 1971;;32:188-198.
34 +
Hockfelt R, Ruxe K:  Effects of prolactin and ergot alkaloids on the tuberoinfundibular dopamine (DA) neurons . Neuroendocrinology 1972;;9:100-122.
35 +
Cushing H: Studies in Intracranial Physiology and Surgery . London, Oxford University Press, 1926;.

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