Skip to main content
SpringerLink
Log in

Cushing’s disease and marked hyperprolactinemia in a patient with a pituitary macroadenoma: effectiveness of bromocriptine treatment

  • Case Report
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

The case of a young boy bearing a pituitary PRL secreting adenoma (20–30,000 ng/ml) with the unusual association of clinical and endocrinological features of Cushing’s disease successfully treated with bromocriptine is described. Brain computed tomography evidenced a huge pituitary adenoma leading to visual field defects and raised intracranial pressure. Due to the very large size of the tumor, which rendered the complete neurosurgical removal unlikely, medical treatment with bromocriptine (10 mg/day) was started. Follow-up for more than six months demonstrated an impressive reduction of tumor size, the lowering of prolactin levels into the normal range, the normalization of visual field, and the regression of both clinical and biochemical signs of hypercortisolism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Muller O.A., Fink R., von Werder K., Scriba P.C. Hypersecretion of ACTH, growth hormone and prolactin in a patient with pituitary adenoma. Acta Endocrinol. (Kbh) (Suppl.) 215: 4, 1978.

    Google Scholar 

  2. Sherry S.H., Guay AT., Lee A.K., Hedley-White E. T., Federman M., Freidberg S.R., Woolf P.D. Concurrent production of adrenocorticotropin and pro lactin from two distinct cell lines in a single pituitary adenoma: a detailed immunohistochemical analysis. J. Clin. Endocrinol. Metab. 55: 947, 1982.

    Article  CAS  PubMed  Google Scholar 

  3. Porter C.C., Silber R.H. A quantitative color reaction for cortisone and related 17, 21-dihydroxy-20-ketosteroids. J. Biol. Chem. 785: 201, 1950.

    Google Scholar 

  4. Drekter I.J., Pearson S., Bartczack E., McGavack T.H. Rapid method for determination of total urinary 17-ke-tosteroids. J. Clin. Endocrinol. Metab. 7: 795, 1947.

    Article  CAS  PubMed  Google Scholar 

  5. Levin M.E., Daughaday W.H., Levy I. Persistent lactation associated with pituitary tumor and hyperadrenal corticism. Am. J. Med. 27: 172, 1959.

    Article  CAS  PubMed  Google Scholar 

  6. Mahesh V.B., Dalla Pria S., Greenbalt R.B. Abnormal lactation with Cushing’s syndrome. A. case report. J. Clin. Endocrinol. Metab. 29: 978, 1969.

    Article  CAS  PubMed  Google Scholar 

  7. Young R.L., Bradley E.M., Goldzieher J.W., Myers P.W. Lecocq F.R. Spectrum of nonpuerperal galactorrhea: report of two cases evolving through the various syndrome. J. Clin. Endocrinol. Metab. 27: 461, 1967.

    Article  CAS  PubMed  Google Scholar 

  8. Kuwayama A., Kageyama N., Nakane T., Watanabe M., Kanie N. Anterior pituitary function after transsphenoidal selective adenomectomy in patients with Cushing’s disease. J. Clin. Endocrinol. Metab. 53: 165, 1981.

    Article  CAS  PubMed  Google Scholar 

  9. Bigos S.T., Robert F., Pelletier G., Hardy J. Cure of Cushing’s disease by transsphenoidal removal of a microadenoma from a pituitary gland despite a radiologically normal sella turcica. J. Clin. Endocrinol. Metab. 45: 1251, 1977.

    Article  CAS  PubMed  Google Scholar 

  10. Bigos S.T., Somma M., Rasio E., Eastman R.C., Lanthier A., Johnston N.H., Hardy J. Cushing’s disease: management by transsphenoidal pituitary microsurgery. J. Clin. Endocrinol. Metab., 50: 348, 1980.

    Article  CAS  PubMed  Google Scholar 

  11. Lamberts S.W.J., Timmermans H.A.T., de Jong F.H., Birkenhager J.C. The role of dopaminergic depletion in the pathogenesis of Cushing’s disease and the possible consequences for medical therapy. Clin. Endocrinol. (Oxf). 7: 185, 1977.

    Article  CAS  PubMed  Google Scholar 

  12. Fiedler R., Krieger D.T. Endocrine disturbances in patients with congenital acqueductal stenosis. Acta Endocrinol. (Kbh.) 80: 1, 1975.

    CAS  Google Scholar 

  13. Chiodini P.G., Liuzzi A., Cozzi R., Verde G., Oppizzi G., Dallabonzana D., Spelta B., Silvestrini F., Borghi P.G., Luccarelli G., Rainer E., Horowski R. Size reduction of macroprolactinomas by bromocriptine and lisuride treatment. J. Clin. Endocrinol. Metab. 53: 737, 1981.

    Article  CAS  PubMed  Google Scholar 

  14. Kapcala L.P., Jackson I.M.D. Long term bromocriptine therapy in pushing’s disease. J. Endocrinol. Invest. 5: 117, 1982.

    CAS  PubMed  Google Scholar 

  15. Lamberts S.W.J., Kliin J.G.M., Dequijada M., Timmermans H.A.T., Vitterlinden P., de Joing F.H., Birkenhagen J.C. The mechanism of the suppressive action of bromocriptine on the adrenocorticotropin secretion in patients with Cushing’s disease and Nelsons’s syndrome. J. Clin. Endocrinol. Metab. 51: 307, 1980.

    Article  CAS  PubMed  Google Scholar 

  16. Silvestrini F., Gelli D., Frascatani F., Muratori F., Loli P., Ronzoni M., Botalla L. Results of long term treatment with bromocriptine in pituitary dependent Cushing’s disease. Acta Endocrinol. (Kbh) (Suppl.) 24: 299, 1981.

    Google Scholar 

  17. Liuzzi A., Chiodini P.G., Oppizzi G., Dallabonzana R. Medical treatment of pituitary adenomas: effects on hormonal secretion and tumor size. In: Calne D.B., Horowski R., McDonald R.J., Wuttke W. (Eds.), Lisuride and other dopamine agonists. Raven Press, New York, 1983, p. 231.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, 20162, Milano, Italy

    G. Verde, P. Loli, M. E. Berselli, M. Tagliaferri, D. Dallabonzana, G. Oppizzi, A. Liuzzi & P. G. Chiodini

  2. Istituto Neurologico C. Besta, Via Celoria 10, 20133, Milano, Italy

    G. Luccarelli & S. Lodrini

Authors
  1. G. Verde
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Loli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. E. Berselli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Tagliaferri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Dallabonzana
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Oppizzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Liuzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P. G. Chiodini
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. G. Luccarelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S. Lodrini
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported by CNR, Special Project “Control of Neoplastic Growth”, grant no 810139296.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verde, G., Loli, P., Berselli, M.E. et al. Cushing’s disease and marked hyperprolactinemia in a patient with a pituitary macroadenoma: effectiveness of bromocriptine treatment. J Endocrinol Invest 7, 51–54 (1984). https://doi.org/10.1007/BF03348376

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03348376

Key-words

Search

Navigation