ergoline and Empty-Sella-Syndrome

Prolactinomas are typically treated nonsurgically with a dopamine agonist. Once the tumor shrinks, adjacent eloquent structures, such as the optic apparatus, can become skeletonized and herniate into the dilated parasellar space.. A 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline presented with progressive bitemporal hemianopsia. Magnetic resonance imaging showed no recurrence of disease and a stretched optic chiasm herniating into an empty sella. Elevation of the optic chiasm via a transnasal transsphenoidal approach with ALLODERM graft and septal cartilage strut was performed. The patient was discharged home the next day with significant improvement in vision; magnetic resonance imaging showed interval elevation of the optic chiasm.. We review secondary empty sella syndrome and discuss surgical strategies for optic chiasmapexy.

Topics: Cabergoline; Dopamine Agonists; Empty Sella Syndrome; Ergolines; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Optic Chiasm; Pituitary Neoplasms; Prolactinoma; Treatment Outcome

The purpose of this study is to demonstrate the added value of intraoperative MRI in treating secondary empty sella syndrome.. We describe the case of a 66-year-old woman who was diagnosed with a prolactinoma stage IIIb. During treatment with cabergoline she presented with a secondary empty sella syndrome resulting in visual symptoms. We performed intraoperative MRI-guided packing of the secondary empty sella. We explain why this is useful in surgical treatment of secondary empty sella syndrome.. Intraoperative MRI helps to achieve adequate sellar packing while avoiding insufficient packing as well as overpacking.

Topics: Aged; Cabergoline; Empty Sella Syndrome; Ergolines; Female; Humans; Magnetic Resonance Imaging; Pituitary Neoplasms; Prolactinoma; Treatment Outcome; Visual Fields

Three patients with hyperprolactinemia due to pituitary adenomas (two patients) or empty sella (one patient) and osteopenia are described. Their ages at presentation ranged from 8 to 17 years. Each patient was treated with cabergoline. Serum prolactin levels became normal in all patients within one month. Bone density and pubertal stage improved after 12 months of treatment.

Topics: Adolescent; Antineoplastic Agents; Bone Density; Bone Diseases, Metabolic; Cabergoline; Child; Empty Sella Syndrome; Ergolines; Female; Humans; Hyperprolactinemia; Male; Pituitary Neoplasms; Prolactinoma; Puberty, Delayed

We performed 113 new treatments in 98 patients (pts) (69 females and 27 males), 41 with macroprolactinoma, 26 with microprolactinoma, 5 with empty sella and 26 with idiopathic hyperprolactinemia. Parlodel LA was administered in 31/113, Parlodel LAR in 51/113, Parlodel SRO in 24/113 and Cabergoline in 8/113. In each pt the clinical effect, PRL plasma level CT-scan and visual field examination were monitored. PRL plasma levels normalized in 84/98 pts. In 13/41 macroadenoma pts a complete disappearance of the adenomatous mass was observed at CT-scan after 0.5-3 years' oral bromocriptine or Parlodel LAR therapy. The clinical features normalized in most of the pts. In conclusion, the new long acting dopamine agonists may represent the future of the management of hyperprolactinemic states because of their effectiveness, tolerability and good compliance.

Topics: Adenoma; Bromocriptine; Cabergoline; Delayed-Action Preparations; Empty Sella Syndrome; Ergolines; Female; Humans; Hyperprolactinemia; Male; Pituitary Neoplasms