Endocrine Abstracts

Introduction

Cabergoline seems to be a promising and effective medical treatment for the more agressive Non Functioning Pituitary Adenomas (NFPAs) by reducing or keeping tumor’s size stable long-term. Here we present the experience of our center

Methods

We studied 7 patients with NFPAs attending our clinic the last 10 years (median period 42 months, range 12 to 114 months), in whom cabergoline was started due to threatening tumor rise approaching the optic chiasm. Five patients had prior pituitary surgery (transsphenoidal, and 2/5 an additional transcranial) for aggressive adenomas compressing the optic chiasm, histological and immunohistochemical findings negative for intact pituitary hormone expression and significant residual tumor or tumor regrowth post surgery. The other 2/7 had macroadenomas approaching the optic chiasm. We evaluated tumor’s mass (cm), tumor’s volume (cm³), visual fields and pituitary function before and twenty-four months after the initiation of cabergoline. Τumor shrinkage > 25% from the baseline is considered significant, although even stabilization or reduction of the tumor at least 10% is consindered very important.

Results

Μean age of the patients was 67.29 ± 8.97 years old and mean cabergoline dose was 2.1 ± 0.95 mg/week. Mean tumor volume at baseline was 8.78 ± 6.73 cm³ and on cabergoline 8.19 ± 6.50 cm³ and 7.87 ± 6.56 cm³ at six and twenty-four months respectively. 2/7 patients (28.57%) had no change on tumor volume during the study period. At six months in 2/7 (28.57%) a volume reduction less than 10% (4.76%, 3.57%) was observed and in 3/7 (42.85%) a reduction more than 10% (19.23%, 15.98%, 18.51%). After twenty-four months from baseline in 1/7 patient (14.28%) there was a volume reduction less than 10% (7.42%), in 3/7 (42.85%) a reduction more than 10% (15.98%, 15.58%, 23.55%) and in 1/7 patient (14.28%) a reduction more than 25% (61.69%). All patients had a remarkable improvement on visual fields defects. Hormonal hypersecression and side effects were not noted.

Conclusion

Our data indicate that cabergoline could be beneficial for aggressive NFPAs. However long-term trials with more participants are needed for more reliable and accurate conclusions.