Pituitary Tumors: Viewpoint— Medical Therapy

  • Rachel L. Hopkins


Tumors can arise from any of the cell types that make up the pituitary gland. The role of medical therapy in pituitary adenomas varies depending on the tumor subtype. In the case of prolactinomas, medical therapy is the primary treatment. For all other tumors of pituitary origin, surgery is the primary therapy with medical therapy playing an adjunctive role sometimes in conjunction with radiation therapy. This brief chapter gives an overview of the use of medical therapy in treating pituitary tumors. Ultimately, a multidisciplinary approach is beneficial in the management of most pituitary tumors.


Pituitary Adenoma Dopamine Agonist Carpal Tunnel Syndrome Pituitary Tumor Pituitary Apoplexy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Kars M, Souberein PC, Herings RM, Romijn JA, Vandenbroucke JP, DeBoer A, Dekkers OM. Estimated age- and sex-specific incidence and prevalence of dopamine agonist-treated hyperprolactinemia. J Clin Endocrinol Metab. 2009;94(8):2729–34.CrossRefPubMedGoogle Scholar
  2. 2.
    Schlechte J, Walkner L, Kathol M. A longitudinal analysis of premenopausal bone loss in healthy women and women with hyperprolactinemia. J Clin Endocrinol Metab. 1992;75(3):698–703.PubMedGoogle Scholar
  3. 3.
    Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechter JA, Wass JA. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273–88.CrossRefPubMedGoogle Scholar
  4. 4.
    Nieman L, Biller BMK, Findling JW, Newell-Price J, Savage MO, Stewart PM, Montori VM. The diagnosis of Cushing’s syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(5):1526–40.PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    Kelly DF. Transsphenoidal surgery for Cushing’s disease: a review of success rates, remission predictors, management of failed surgery, and Nelson’s syndrome. J Neurosurg Focus. 2007;23(3): 1–6.CrossRefGoogle Scholar
  6. 6.
    Petrossians P, Thonnard A, Beckers A. Medical treatment in Cushing’s syndrome: dopamine agonists and cabergoline. Neuroendocrinology. 2010;92 Suppl 1:116–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Pedroncelli A. Medical treatment of Cushing’s disease: somatostatin analogues and pasireotide. Neuroendocrinology. 2010;92 Suppl 1:120–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Castinetti F, Brue T, Conte-Devolx B. The use of glucocorticoid receptor antagonist mifepristone in Cushing’s syndrome. Curr Opin Endocrinol Diabetes Obes. 2012;19(4):295–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Katznelson L, Atkinson JLD, Cook DM, Ezzat SZ, Hamrahian AH, Miller KK. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly—2011 update. Endocr Pract. 2011;17 Suppl 4:1–44.CrossRefPubMedGoogle Scholar
  10. 10.
    Ludlam WH, Anthony L. Safety review: dose optimization of somatostatin analogs in patients with acromegaly and neuroendocrine tumors. Adv Ther. 2011;28(10):825–41.CrossRefPubMedGoogle Scholar
  11. 11.
    Sandret L, Maison P, Chanson P. Place of cabergoline in acromegaly: a meta-analysis. J Clin Endocrinol Metab. 2011;96(5): 1327–35.CrossRefPubMedGoogle Scholar
  12. 12.
    Buhk JH, Jung S, Psychogios MN, Goricke S, Hartz S, Schulz-Heise S, Klingebiel R, Forsting M, Bruckmann H, Dorfler A, Jordan M, Buchfelder M, Knauth M. Tumor volume of growth hormone-secreting pituitary adenomas during treatment with pegvisomant: a prospective multicenter study. J Clin Endocrinol Metab. 2010;95(2):552–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Sherlock M, Woods C, Sheppard MC. Medical therapy in acromegaly. Nat Rev Endocrinol. 2011;7:291–300.CrossRefPubMedGoogle Scholar
  14. 14.
    Meyers A, Hatanpaa KJ, Madden C, Lingvay I. Thyrotropin-secreting adenoma in a patient with primary hypothyroidism. Endocr Pract. 2011;17(6):135–9.CrossRefGoogle Scholar
  15. 15.
    Socin HV, Chanson P, Delemer B, Tabarin A, Rohmer V, Mockel J, Stevenaert A, Beckers A. The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients. Eur J Endocrinol. 2003;148(4):433–42.CrossRefPubMedGoogle Scholar
  16. 16.
    Macchia E, Gasperi M, Lombardi M, Morselli L, Pinchera A, Acerbi G, Rossi G. Clinical aspects and therapeutic outcome in thyrotropin-secreting pituitary adenomas: a single center experience. J Endocrinol Invest. 2009;32:773–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Beck-Peccoz P, Persani L, Mannavola D, Campi I. TSH-secreting adenomas. Best Pract Res Clin Endocrinol Metab. 2009;23:597–606.CrossRefPubMedGoogle Scholar
  18. 18.
    Daousi C, Foy PM, MacFarlane IA. Ablative thyroid treatment for thyrotoxicosis due to thyrotropin-producing pituitary tumors. J Neurol Neurosurg Psychiatry. 2007;78(1):93–5.PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Knoepfelmacher M, Danilovic DLS, Nasser RHRR, Mendonca BB. Effectiveness of treating ovarian hyperstimulation syndrome with cabergoline in two patients with gonadotropin-producing pituitary adenomas. Fertil Steril. 2006;86(3):15–8.CrossRefGoogle Scholar
  20. 20.
    Chen Y, Wang CD, Su ZP, Chen YX, Cai L, Zhuge QC, Wu ZB. Natural history of postoperative nonfunctioning pituitary adenomas: a systematic review and meta-analysis. Neuroendocrinology. 2012;96(4):333–42.CrossRefPubMedGoogle Scholar
  21. 21.
    Chang EF, Zada G, Kim S, Lamborn KR, Quinones-Hinojosa A, Tyrrell JB, Wilson CB, Kunwar S. Long-term recurrence and mortality after surgery and adjuvant radiotherapy for nonfunctional pituitary adenomas. J Neurosurg. 2008;108:736–45.CrossRefPubMedGoogle Scholar
  22. 22.
    Shomali ME, Katznelson L. Medical therapy of gonadotropin-producing and nonfunctioning pituitary adenomas. Pituitary. 2002; 5(2):89–98.CrossRefPubMedGoogle Scholar
  23. 23.
    Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinically nonfunctioning pituitary macroadenomas. J Clin Endocrinol Metab. 2008;93(10):3717–26.CrossRefPubMedGoogle Scholar
  24. 24.
    Pereirra AM, Biermasz NR. Treatment of nonfunctioning pituitary adenomas: what were the contributions of the last 10 years? Ann Endocrinol (Paris). 2012;73(2):111–6.CrossRefGoogle Scholar
  25. 25.
    Cooper O, Melmed S. Subclinical hyperfunctioning pituitary adenomas: the silent tumors. Best Pract Res Clin Endocrinol Metab. 2012;26:447–60.PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Cooper O, Ben-Shlomo A, Bonert V, Bannykh S, Mirocha J, Melmed S. Silent corticogonadotroph adenomas: clinical and cellular characteristics and long-term outcomes. Horm Cancer. 2010; 1(2):80–92.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Endocrinology & MetabolismState University of New York Upstate Medical UniversitySyracuseUSA

Personalised recommendations