دورية أكاديمية
أعرض في EDS

Macroprolactinoma with secondary resistance to dopamine agonists: a case report and review of the literature.

التفاصيل البيبلوغرافية
العنوان: Macroprolactinoma with secondary resistance to dopamine agonists: a case report and review of the literature.
المؤلفون: Tng EL; Department of Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Tower A Level 8, Singapore, 609606, Singapore. tngengloon@gmail.com., Teo AE; Department of Medicine, Division of Endocrinology, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore, 119228, Singapore., Aung AT; Ministry of Health Holdings, 1 Maritime Square, #11-25 HarbourFront Centre, Singapore, 099253, Singapore.
المصدر: Journal of medical case reports [J Med Case Rep] 2023 Mar 17; Vol. 17 (1), pp. 96. Date of Electronic Publication: 2023 Mar 17.
نوع المنشور: Review; Case Reports; Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, [2007-
مواضيع طبية MeSH: Prolactinoma* , Pituitary Neoplasms*/pathology, Male ; Humans ; Middle Aged ; Dopamine Agonists/therapeutic use ; Cabergoline/therapeutic use ; Ergolines/therapeutic use ; Prolactin
مستخلص: Background: Resistance to dopamine agonists is not uncommonly seen in prolactinomas. However, development of resistance to dopamine agonists after an initial period of robust treatment response is rare, and only 39 cases have been reported in the past four decades. We describe a Chinese man with this rare condition and explored the postulated mechanisms that may explain this phenomenon. We compiled similar cases that were previously reported and compared their etiology, progress, and response to treatment. On the basis of these cases, we derived a list of differential diagnoses to consider in patients with secondary resistance to dopamine agonists.
Case Presentation: A 63-year-old Chinese man presented with blurred vision and was subsequently diagnosed with a macroprolactinoma. He had initial response to cabergoline but developed secondary resistance to it after 5 years. The prolactinoma continued to grow, and his serum prolactin remained markedly elevated despite adherence to escalating dosages of cabergoline up to 6 mg/week. The patient finally underwent transsphenoidal surgery and was found to have a sparsely granulated lactotroph tumor with Ki-67 index of 5%. Postoperatively, there was improvement in his serum prolactin level, although he still required treatment with cabergoline at 6 mg/week.
Conclusions: Surgery can facilitate disease control in patients with prolactinomas that develop secondary resistance to dopamine agonists. Malignant prolactinoma is an important differential diagnosis in this group of patients, especially when serum prolactin remains markedly elevated despite resolution or stability of the primary pituitary lesion, suggesting a metastatic source of prolactin secretion.
(© 2023. The Author(s).)
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فهرسة مساهمة: Keywords: Bromocriptine; Cabergoline; Case report; Dopamine agonists; Macroprolactinoma; Pergolide; Prolactin-secreting adenoma; Quinagolide; Secondary resistance
المشرفين على المادة: 0 (Dopamine Agonists)
LL60K9J05T (Cabergoline)
0 (Ergolines)
9002-62-4 (Prolactin)
تواريخ الأحداث: Date Created: 20230317 Date Completed: 20230320 Latest Revision: 20230320
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10021939
DOI: 10.1186/s13256-023-03820-5
PMID: 36927797
قاعدة البيانات: MEDLINE
الوصف
تدمد:1752-1947
DOI:10.1186/s13256-023-03820-5