MRI follow-up is unnecessary in patients with macroprolactinomas and long-term normal prolactin levels on dopamine agonist treatment
| Autor: | Thomas Cuny, Thierry Brue, Isabelle Tejedor, Georges Weryha, Albert Beckers, Philippe Touraine, J F Bonneville, Henry Dufour, Iulia Potorac, Juliette Eroukhmanoff, Frederic Castinetti |
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| Přispěvatelé: | Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service d'Endocrinologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Science et Ingénierie des Matériaux et Procédés (SIMaP ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre de recherche en neurobiologie - neurophysiologie de Marseille (CRN2M), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), centre hospitalier universitaire de liège, Service d'endocrinologie clinique |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Cabergoline Endocrinology Diabetes and Metabolism [SDV]Life Sciences [q-bio] 030209 endocrinology & metabolism Asymptomatic Dopamine agonist 03 medical and health sciences 0302 clinical medicine Endocrinology Belgium Dopamine Internal medicine medicine Humans Pituitary Neoplasms Prolactinoma 030212 general & internal medicine Macroprolactinoma Ergolines Bromocriptine Retrospective Studies medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism Middle Aged medicine.disease Magnetic Resonance Imaging Prolactin 3. Good health Dopamine Agonists Aminoquinolines Female France medicine.symptom business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology medicine.drug Follow-Up Studies |
| Zdroj: | European Journal of Endocrinology European Journal of Endocrinology, BioScientifica, 2017, 176 (3), pp.323-328. ⟨10.1530/EJE-16-0897⟩ European Journal of Endocrinology, 2017, 176 (3), pp.323-328. ⟨10.1530/EJE-16-0897⟩ |
| ISSN: | 1479-683X 0804-4643 |
| Popis: | Objective Both antitumor and antisecretory efficacies of dopamine agonists (DA) make them the first-line treatment of macroprolactinomas. However, there is no guideline for MRI follow-up once prolactin is controlled. The aim of our study was to determine whether a regular MRI follow-up was necessary in patients with long-term normal prolactin levels under DA. Patients and methods We conducted a retrospective multicenter study (Marseille, Paris La Pitie Salpetriere and Nancy, France; Liege, Belgium) including patients with macroprolactinomas (largest diameter: >10 mm and baseline prolactin level: >100 ng/mL) treated by dopamine agonists, and regularly followed (pituitary MRI and prolactin levels) during at least 48 months once normal prolactin level was obtained. Results In total, 115 patients were included (63 men and 52 women; mean age at diagnosis: 36.3 years). Mean baseline prolactin level was 2224 ± 6839 ng/mL. No significant increase of tumor volume was observed during the follow-up. Of the 21 patients (18%) who presented asymptomatic hemorrhagic changes of the macroprolactinoma on MRI, 2 had a tumor increase (2 and 7 mm in the largest size). Both were treated by cabergoline (1 mg/week) with normal prolactin levels obtained for 6 and 24 months. For both patients, no further growth was observed on MRI during follow-up at the same dose of cabergoline. Conclusion No significant increase of tumor size was observed in our patients with controlled prolactin levels on DA. MRI follow-up thus appears unnecessary in patients with biologically controlled macroprolactinomas. |
| Databáze: | OpenAIRE |
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