Treatment of pituitary adenomas
Authors:
Jana Ježková; Josef Marek; Manuela Vaněčková
Authors‘ workplace:
Radiodiagnostická klinika 1. LF UK a VFN v Praze
; 3. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in:
Čas. Lék. čes. 2017; 156: 266-270
Category:
Review Article
Overview
Pituitary adenomas are the most common tumours of the sellar region. A combination of neurosurgery, radiation and pharmacological approaches are applied for the treatment of pituitary adenomas. In certain cases, patient observation is another option. Neurosurgery is the first-choice treatment for acromegaly, Cushing´s disease and TSH secreting adenomas. Leksell gamma knife irradiation is used in the treatment of tumour residues. Until the effect of the irradiation is evident, pharmacological treatment must be administered. Large and/or growing non-functioning pituitary adenomas are operated. Irradiation is possible if there is sufficient distance between the margin of the adenoma and the optic pathway. The primary therapy for prolactinomas is pharmacological treatment with dopamine agonists. Multidisciplinary collaboration among endocrinologists, neurosurgeons and radiosurgeons is necessary in the treatment of pituitary adenomas.
Keywords:
pituitary adenoma, acromegaly, Cushing´s disease, prolactinoma, gamma knife, hypopituitarism
Sources
1. Ezzat S, Asa SL, Couldwell WT et al. The prevalence of pituitary adenomas: a systematic review. Cancer 2004; 101 (3): 613–619.
2. Daly AF, Rixhon M, Adam C et al. High prevalence of pituitary adenomas: a cross-sectional study on the province of Liege, Belgium. J Clin Endocrinol Metab 2006; 91(12): 4769–4775.
3. Fernandez A, Karavitaki N, Wass JA. Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol 2010; 72(3): 377–382.
4. Netuka D, Masopust V, Beneš V. Léčba adenomů hypofýzy. Česk Slov Neurol N 2011; 74/107 (3): 240–253.
5. Liščák R. Adenom hypofýzy. In: Liščák R. (ed.). Radiochirurgie gama nožem. Grada Publishing, Praha, 2009: 114–127.
6. Marek J, Ježková J, Hána V et al. Is it possible to avoid hypopituitarism after irradiation of pituitary adenomas by the Leksell gamma knife? Eur J Endocrinol 2011; 164: 169–178.
7. Rains CP, Bryson HM, Fitton A. Cabergoline. A review of its pharmacological properties and therapeutic potential in the treatment of hyperprolactinemia and inhibition lactation. Drugs 1995; 49: 255–279.
8. Webster J. A comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinemia and inhibition lactation. Drug Saf 1996; 14 (4): 228–238.
9. Colao A, di Sarno A, Pivonello R et al. Dopamine receptor agonists for treating prolactinomas. Expert Opin Investig Drugs 2002; 11: 787–800.
10. Webster J, Piscitelli G, Polli A et al. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline comparative study group. N Engl J Med 1994; 331(14): 904–909.
11. Colao A, Di Sarno A, Sarnacchiaro F et al. Prolactinoma resistant to standard dopamine agonists respond to chronic cabergoline treatment. J Clin Endocrinol Metab 1997; 82(3): 876–883.
12. Colao A, Di Sarno A, Cappabianca P et al. Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia. N Engl J Med 2003; 349 (21): 2023–2033.
13. Colao A, Di Sarno A, Landi ML et al. Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 1997; 82: 3574–3579.
14. Gillam MP, Molitch ME, Lombardi G, Colao A. Advances in the treatment of prolactinomas. Endocr Rev 2006; 27(5): 485–534.
15. Kaltsas GA, Isidori AM, Florakis D et al. Predictors of the outcome of surgical treatment in acromegaly and the value of the mean growth hormone day curve in assessing postoperative disease activity. J Clin Endocrinol Metab 2001; 86: 1645–1652.
16. Nomikos P, Buchfelder M, Fahlbusch R. The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical "cure". Eur J Endocrinol 2005; 152: 379–387.
17. Ludecke DK, Abe T. Transsphenoidal microsurgery for newly diagnosed acromegaly: a personal view after more than 1.000 operations. Neuroendocrinology 2006; 83: 230–239.
18. Ježková J, Marek J, Hána V et al. Gamma knife radiosurgery for acromegaly. Clin Endocrinol 2006; 64: 588–595.
19. Sandret L, Maison P, Chanson P. Place of cabergoline in acromegaly: a meta-analysis. J Clin Endocrinol Metab 2011; 96: 1327–1335.
20. Abs R, Verhelst J, Maiter D et al. Cabergoline in the treatment of acromegaly: a study in 64 patients. J Clin Endocrinol Metab 1998; 83: 374–378.
21. Murray RD, Melmed S. A critical analysis of clinically available somatostatin analog formulations for therapy of acromegaly. J Clin Endocrinol Metab 2008; 93: 2957–2968.
22. Giustina A, Mazziotti G, Torri V et al. Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One 2012; 7: e36411.
23. Van der Lely AJ, Biller BM, Brue T et al. Long-term safety of pegvisomant in patients with acromegaly: comprehensive review of 1288 subjects in ACROSTUDY. J Clin Endocrinol Metab 2012; 97: 1589–1597.
24. Alexandraki KI, Kaltsas GA, Isidori AM et al. Long-term remission and recurrence rates in Cushing's disease: predictive factors in a single-centre study. Eur J Endocrinol 2013; 168: 639–648.
25. Aranda G, Ensenat J, Mora M et al. Long-term remission and recurrence rate in a cohort of Cushing's disease: the need for long-term surveillance. Clin Endocrinol 2005; 63: 549–559.
26. Marek J, Ježková J, Hána V et al. Gamma knife radiosurgery for Cushing's disease and Nelson's syndrome. Pituitary 2015; 18 (3): 376–384.
27. Colao A, Petersenn S, Newell-Price J et al. A 12-month phase 3 study of pasireotide in Cushing's disease. N Engl J Med 2012; 366: 914–924.
28. Beck-Peccoz P, Brucker-Davis F, Persani L et al. Thyrotropin-secreting pituitary tumors. Endocr Rev 1996; 17: 610–638.
29. Yamada S, Fukuhara N, Horiguchi K et al. Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg 2014; 121: 1462–1473.
30. Kirkman MA, Jaunmutkane Z, Brandner S et al. Active and silent thyroid-stimulating hormone-expressing pituitary adenomas: presenting symptoms, treatment, outcomes, and recurrence. World Neurosurg 2014; 82: 1224–1231.
31. Kuhn JM, Arlot S, Lefebvre H et al. Evaluation of the treatment of thyroid-secreting pituitary adenomas with a slow release of the somatostatin analog lanreotide. J Clin Endocrinol Metab 2000; 85: 1487–1491.
32. Caron P, Arlot S, Bauters C et al. Efficacy of the long-acting octreotide formulation (octreotide –LAR) in patients with thyrotropin-secreting pituitary adenomas. J Clin Endocrinol Metab 2001; 86: 2849–2853.
33. Beck-Peccoz P, Persani L. Medical management of thyrotropin-secreting pituitary adenomas. Pituitary 2002; 5: 83–88.
34. Karavitaki N, Collinson K, Halliday J et al. What is the natural history of nonoperated nonfunctioning pituitary adenomas? Clin Endocrinol 2007; 67: 938–943.
35. Dekkers OM, Hammer S, de Keizer RJ et al. The natural course of non-functioning pituitary macroadenomas. Eur J Endocrinol 2007; 156: 217–224.
36. Wakai S, Fukushima T, Teramoto A et al. Pituitary apoplexy: its incidence and clinical significance. J Neurosurg 1981; 55: 187–193.
37. Woollons AC, Hunn MK, Rajapakse YR et al. Non-functioning pituitary adenomas: indications for postoperative radiotherapy. Clin Endocrinol 2000; 53(6): 713–717.
38. Pivonello R, Matrone C, Filippella M et al. Dopamine receptor expression and function in clinically functioning pituitary tumors: comparison with the effectiveness of cabergoline treatment. J Clin Endocrinol Metab 2004; 89: 1674–1683.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
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