Secondary resistance to cabergoline therapy in a macroprolactinoma: a case report and literature review.

Hdl Handle:
http://hdl.handle.net/10147/207278
Title:
Secondary resistance to cabergoline therapy in a macroprolactinoma: a case report and literature review.
Authors:
Behan, L A; Draman, M S; Moran, C; King, T; Crowley, R K; O'Sullivan, E P; Smith, D; Thompson, C J; Agha, A
Affiliation:
Department of Academic Endocrinology and Diabetes, Beaumont Hospital and RCSI, Medical School, Dublin 9, Ireland. lucyannbehan@beaumont.i.e
Citation:
Pituitary. 2011 Dec;14(4):362-6.
Journal:
Pituitary
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207278
DOI:
10.1007/s11102-009-0168-0
PubMed ID:
19191028
Abstract:
Primary resistance to dopamine agonists occurs in 10-15% of prolactinomas but secondary resistance following initial biochemical and anti-proliferative response is very rare and has only been hitherto described in four previous cases, two with bromocriptine and two with cabergoline. We describe a case of a 57-year-old woman who presented with a large macroprolactinoma with suprasellar extension. She was initially treated with bromocriptine therapy with a resolution of symptoms, marked reduction in prolactin concentration and complete tumour shrinkage; a response which was subsequently maintained on cabergoline. After 8 years of dopamine agonist therapy, her prolactin concentration began to rise and there was symptomatic recurrence of her tumour despite escalating doses of cabergoline up to 6 mg weekly. Non-compliance was outruled by observed inpatient drug administration. The patient underwent surgical debulking followed by radiotherapy with good response. This case adds to the previous two cases of secondary resistance to cabergoline therapy in prolactinomas a marked initial response. While the mechanism of secondary resistance remains unknown and not possible to predict, close observation of prolactinoma patients on treatment is necessary.
Language:
eng
MeSH:
Antineoplastic Agents/therapeutic use; *Drug Resistance, Neoplasm/physiology; Drug Tolerance/physiology; Ergolines/*therapeutic use; Female; Humans; Middle Aged; Pituitary Neoplasms/*drug therapy; Prolactinoma/*drug therapy
ISSN:
1573-7403 (Electronic); 1386-341X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBehan, L Aen_GB
dc.contributor.authorDraman, M Sen_GB
dc.contributor.authorMoran, Cen_GB
dc.contributor.authorKing, Ten_GB
dc.contributor.authorCrowley, R Ken_GB
dc.contributor.authorO'Sullivan, E Pen_GB
dc.contributor.authorSmith, Den_GB
dc.contributor.authorThompson, C Jen_GB
dc.contributor.authorAgha, Aen_GB
dc.date.accessioned2012-02-01T10:03:51Z-
dc.date.available2012-02-01T10:03:51Z-
dc.date.issued2012-02-01T10:03:51Z-
dc.identifier.citationPituitary. 2011 Dec;14(4):362-6.en_GB
dc.identifier.issn1573-7403 (Electronic)en_GB
dc.identifier.issn1386-341X (Linking)en_GB
dc.identifier.pmid19191028en_GB
dc.identifier.doi10.1007/s11102-009-0168-0en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207278-
dc.description.abstractPrimary resistance to dopamine agonists occurs in 10-15% of prolactinomas but secondary resistance following initial biochemical and anti-proliferative response is very rare and has only been hitherto described in four previous cases, two with bromocriptine and two with cabergoline. We describe a case of a 57-year-old woman who presented with a large macroprolactinoma with suprasellar extension. She was initially treated with bromocriptine therapy with a resolution of symptoms, marked reduction in prolactin concentration and complete tumour shrinkage; a response which was subsequently maintained on cabergoline. After 8 years of dopamine agonist therapy, her prolactin concentration began to rise and there was symptomatic recurrence of her tumour despite escalating doses of cabergoline up to 6 mg weekly. Non-compliance was outruled by observed inpatient drug administration. The patient underwent surgical debulking followed by radiotherapy with good response. This case adds to the previous two cases of secondary resistance to cabergoline therapy in prolactinomas a marked initial response. While the mechanism of secondary resistance remains unknown and not possible to predict, close observation of prolactinoma patients on treatment is necessary.en_GB
dc.language.isoengen_GB
dc.subject.meshAntineoplastic Agents/therapeutic useen_GB
dc.subject.mesh*Drug Resistance, Neoplasm/physiologyen_GB
dc.subject.meshDrug Tolerance/physiologyen_GB
dc.subject.meshErgolines/*therapeutic useen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPituitary Neoplasms/*drug therapyen_GB
dc.subject.meshProlactinoma/*drug therapyen_GB
dc.titleSecondary resistance to cabergoline therapy in a macroprolactinoma: a case report and literature review.en_GB
dc.contributor.departmentDepartment of Academic Endocrinology and Diabetes, Beaumont Hospital and RCSI, Medical School, Dublin 9, Ireland. lucyannbehan@beaumont.i.een_GB
dc.identifier.journalPituitaryen_GB
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.