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DOI: 10.1055/s-2007-984745
Pituitary Tumors: Diagnosis, Management, and Implications for Reproduction
Publication History
Publication Date:
20 August 2007 (online)
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ABSTRACT
Pituitary tumors are the most common intracranial neoplasms. They are commonly encountered by the gynecologist during an evaluation for galactorrhea, menstrual disturbances, or infertility. Although the majority of these tumors are benign, their impact on the endocrine and nervous system can be striking. The availability of neuroimaging techniques has allowed for more rapid diagnosis, affording earlier treatment. This review is intended to describe the common pituitary tumors seen by the gynecologist, and their impact on reproduction and fertility in the female patient.
KEYWORDS
Pituitary - adenoma - reproduction - prolactinoma
REFERENCES
- 1 Burrow G N, Wortzman G, Rewcastle N B et al.. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med. 1981; 304(3) 156-158
- 2 Molitch M E, Russell E J. The pituitary “incidentaloma”. Ann Intern Med. 1990; 112(12) 925-931
- 3 Hall W A, Luciano M G, Doppman J L et al.. Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Ann Intern Med. 1994; 120(10) 817-820
- 4 Ezzat S, Asa S L. Mechanisms of disease: the pathogenesis of pituitary tumors. Nat Clin Pract Endocrinol Metab. 2006; 2(4) 220-230
- 5 Kaltsas G A, Nomikos P, Kontogeorgos G et al.. Clinical review: diagnosis and management of pituitary carcinomas. J Clin Endocrinol Metab. 2005; 90(5) 3089-3099
- 6 Pernicone P J, Scheithauer B W, Sebo T J et al.. Pituitary carcinoma: a clinicopathologic study of 15 cases. Cancer. 1997; 79(4) 804-812
- 7 Ezzat S, Asa S L, Couldwell W T et al.. The prevalence of pituitary adenomas: a systematic review. Cancer. 2004; 101(3) 613-619
- 8 Ruscalleda J. Imaging of parasellar lesions. Eur Radiol. 2005; 15(3) 549-559
- 9 Bonneville J F, Bonneville F, Cattin F. Magnetic resonance imaging of pituitary adenomas. Eur Radiol. 2005; 15(3) 543-548
- 10 Seilicovich A, Pisera D, Sciascia S A et al.. Gene therapy for pituitary tumors. Curr Gene Ther. 2005; 5(6) 559-572
- 11 Modest G A, Fangman J J. Nipple piercing and hyperprolactinemia. N Engl J Med. 2002; 347(20) 1626-1627
- 12 Pollock A, McLaren E H. Serum prolactin concentration in patients taking neuroleptic drugs. Clin Endocrinol (Oxf). 1998; 49(4) 513-516
- 13 Slater S L, Lipper S, Shiling D J et al.. Elevation of plasma-prolactin by monoamine-oxidase inhibitors. Lancet. 1977; 2(8032) 275-276
- 14 Wiegand M, Berger M. Action of trimipramine on sleep and pituitary hormone secretion. Drugs. 1989; 38(suppl) 135-142
- 15 Peterson M C. Reversible galactorrhea and prolactin elevation related to fluoxetine use. Mayo Clin Proc. 2001; 76(2) 215-216
- 16 Steiner J, Cassar J, Mashiter K et al.. Effects of methyldopa on prolactin and growth hormone. BMJ. 1976; 1(6019) 1186-1188
- 17 Fearrington E L, Rand Jr C H, Rose J D. Hyperprolactinemia-galactorrhea induced by verapamil. Am J Cardiol. 1983; 51(8) 1466-1467
- 18 Hou S H, Grossman S, Molitch M E. Hyperprolactinemia in patients with renal insufficiency and chronic renal failure requiring hemodialysis or chronic ambulatory peritoneal dialysis. Am J Kidney Dis. 1985; 6(4) 245-249
- 19 Stryker T D, Molitch M E. Reversible hyperthyrotropinemia, hyperthyroxinemia, and hyperprolactinemia due to adrenal insufficiency. Am J Med. 1985; 79(2) 271-276
- 20 Van Gaal L, Abs R, De Leeuw I et al.. Hypothyroidism and prolactin. Eur J Obstet Gynecol Reprod Biol. 1981; 12(5) 315-321
- 21 Haisenleder D J, Ortolano G A, Dalkin A C et al.. Differential actions of thyrotropin (TSH)-releasing hormone pulses in the expression of prolactin and TSH subunit messenger ribonucleic acid in rat pituitary cells in vitro. Endocrinology. 1992; 130(5) 2917-2923
- 22 Fahie-Wilson M N, John R, Ellis A R. Macroprolactin: high molecular mass forms of circulating prolactin. Ann Clin Biochem. 2005; 42(pt 3) 175-192
- 23 Davis J R. Prolactin and reproductive medicine. Curr Opin Obstet Gynecol. 2004; 16(4) 331-337
- 24 McNeilly A S. Prolactin and the control of gonadotrophin secretion. J Endocrinol. 1987; 115(1) 1-5
- 25 Glasow A, Breidert M, Haidan A et al.. Functional aspects of the effect of prolactin (PRL) on adrenal steroidogenesis and distribution of the PRL receptor in the human adrenal gland. J Clin Endocrinol Metab. 1996; 81(8) 3103-3111
- 26 Vermeulen A, Ando S. Prolactin and adrenal androgen secretion. Clin Endocrinol (Oxf). 1978; 8(4) 295-303
- 27 Lobo R A, Kletzky O A. Normalization of androgen and sex hormone-binding globulin levels after treatment of hyperprolactinemia. J Clin Endocrinol Metab. 1983; 56(3) 562-566
- 28 Frieze T W, Mong D P, Koops M K. “Hook effect” in prolactinomas: case report and review of literature. Endocr Pract. 2002; 8(4) 296-303
- 29 St Jean E, Blain F, Comtois R. High prolactin levels may be missed by immunoradiometric assay in patients with macroprolactinomas. Clin Endocrinol (Oxf). 1996; 44(3) 305-309
- 30 Molitch M E. Disorders of prolactin secretion. Endocrinol Metab Clin North Am. 2001; 30(3) 585-610
- 31 Colao A, Di Sarno A, Landi M L et al.. Macroprolactinoma shrinkage during cabergoline treatment is greater in naive patients than in patients pretreated with other dopamine agonists: a prospective study in 110 patients. J Clin Endocrinol Metab. 2000; 85(6) 2247-2252
- 32 Webster J, Piscitelli G, Polli A et al.. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med. 1994; 331(14) 904-909
- 33 Di Sarno A, Landi M L, Cappabianca P et al.. Resistance to cabergoline as compared with bromocriptine in hyperprolactinemia: prevalence, clinical definition, and therapeutic strategy. J Clin Endocrinol Metab. 2001; 86(11) 5256-5261
- 34 Arafah B M, Nasrallah M P. Pituitary tumors: pathophysiology, clinical manifestations and management. Endocr Relat Cancer. 2001; 8(4) 287-305
- 35 Arafah B M, Brodkey J S, Pearson O H. Gradual recovery of lactotroph responsiveness to dynamic stimulation following surgical removal of prolactinomas: long-term follow-up studies. Metabolism. 1986; 35(10) 905-912
- 36 Molitch M E, Thorner M O, Wilson C. Management of prolactinomas. J Clin Endocrinol Metab. 1997; 82(4) 996-1000
- 37 Schlechte J, Dolan K, Sherman B et al.. The natural history of untreated hyperprolactinemia: a prospective analysis. J Clin Endocrinol Metab. 1989; 68(2) 412-418
- 38 Jeffcoate W J, Pound N, Sturrock N D et al.. Long-term follow-up of patients with hyperprolactinaemia. Clin Endocrinol (Oxf). 1996; 45(3) 299-303
- 39 Klibanski A, Neer R M, Beitins I Z et al.. Decreased bone density in hyperprolactinemic women. N Engl J Med. 1980; 303(26) 1511-1514
- 40 Biller B M, Baum H B, Rosenthal D I et al.. Progressive trabecular osteopenia in women with hyperprolactinemic amenorrhea. J Clin Endocrinol Metab. 1992; 75(3) 692-697
- 41 Klibanski A, Biller B M, Rosenthal D I et al.. Effects of prolactin and estrogen deficiency in amenorrheic bone loss. J Clin Endocrinol Metab. 1988; 67(1) 124-130
- 42 Molitch M E. Management of prolactinomas during pregnancy. J Reprod Med. 1999; 44(12 suppl) 1121-1126
- 43 Molitch M E. Pregnancy and the hyperprolactinemic woman. N Engl J Med. 1985; 312(21) 1364-1370
- 44 Kupersmith M J, Rosenberg C, Kleinberg D. Visual loss in pregnant women with pituitary adenomas. Ann Intern Med. 1994; 121(7) 473-477
- 45 Webster J. A comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinaemia and inhibition of lactation. Drug Saf. 1996; 14(4) 228-238
- 46 Melmed S. Acromegaly. Metabolism. 1996; 45(8 suppl 1) 51-52
- 47 Melmed S, Braunstein G D, Chang R J et al.. Pituitary tumors secreting growth hormone and prolactin. Ann Intern Med. 1986; 105(2) 238-253
- 48 Klibanski A, Zervas N T. Diagnosis and management of hormone-secreting pituitary adenomas. N Engl J Med. 1991; 324(12) 822-831
- 49 Fukuda I, Hizuka N, Murakami Y et al.. Clinical features and therapeutic outcomes of 65 patients with acromegaly at Tokyo Women's Medical University. Intern Med. 2001; 40(10) 987-992
- 50 Blumberg D L, Sklar C A, David R et al.. Acromegaly in an infant. Pediatrics. 1989; 83(6) 998-1002
- 51 Chandrashekar V, Bartke A. The role of insulin-like growth factor-I in neuroendocrine function and the consequent effects on sexual maturation: inferences from animal models. Reprod Biol. 2003; 3(1) 7-28
- 52 Lackey B R, Gray S L, Henricks D M. The insulin-like growth factor (IGF) system and gonadotropin regulation: actions and interactions. Cytokine Growth Factor Rev. 1999; 10(3-4) 201-217
- 53 Barreca A, Artini P G, Del Monte P et al.. In vivo and in vitro effect of growth hormone on estradiol secretion by human granulosa cells. J Clin Endocrinol Metab. 1993; 77(1) 61-67
- 54 Adashi E Y, Resnick C E, D'Ercole A J et al.. Insulin-like growth factors as intraovarian regulators of granulosa cell growth and function. Endocr Rev. 1985; 6(3) 400-420
- 55 Christman G M, Randolph Jr J F, Peegel H et al.. Differential responsiveness of luteinized human granulosa cells to gonadotropins and insulin-like growth factor I for induction of aromatase activity. Fertil Steril. 1991; 55(6) 1099-1105
- 56 Erickson G F, Garzo V G, Magoffin D A. Insulin-like growth factor-I regulates aromatase activity in human granulosa and granulosa luteal cells. J Clin Endocrinol Metab. 1989; 69(4) 716-724
- 57 Minegishi T, Hirakawa T, Abe K et al.. Effect of IGF-1 and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the expression of LH receptors during cell differentiation in cultured granulosa cells. Mol Cell Endocrinol. 2003; 202(1-2) 123-131
- 58 Kaltsas G A, Mukherjee J J, Jenkins P J et al.. Menstrual irregularity in women with acromegaly. J Clin Endocrinol Metab. 1999; 84(8) 2731-2735
- 59 Luboshitzky R, Dickstein G, Barzilai D. Bromocriptine-induced pregnancy in an acromegalic patient. JAMA. 1980; 244(6) 584-586
- 60 Lim N Y, Dingman J F. Androgenic adrenal hyperfunction in acromegaly. N Engl J Med. 1964; 271 1189-1194
- 61 Unal A, Sahin Y, Kelestimur F. Acromegaly with polycystic ovaries, hyperandrogenism, hirsutism, insulin resistance and acanthosis nigricans: a case report. Endocr J. 1993; 40(2) 207-211
- 62 Barkan A L, Beitins I Z, Kelch R P. Plasma insulin-like growth factor-I/somatomedin-C in acromegaly: correlation with the degree of growth hormone hypersecretion. J Clin Endocrinol Metab. 1988; 67(1) 69-73
- 63 Arafah B M, Rosenzweig J L, Fenstermaker R et al.. Value of growth hormone dynamics and somatomedin C (insulin-like growth factor I) levels in predicting the long-term benefit after transsphenoidal surgery for acromegaly. J Lab Clin Med. 1987; 109(3) 346-354
- 64 Giustina A, Barkan A, Casanueva F F et al.. Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab. 2000; 85(2) 526-529
- 65 Matsuno A, Ogino Y, Katayama H et al.. Identification of a silent pituitary somatotropic adenoma based on a paradoxic response of growth hormone on a thyrotropin-releasing hormone or gonadotropin-releasing hormone provocation test. Am J Obstet Gynecol. 2001; 184(3) 286-288
- 66 Halse J, Harris A G, Kvistborg A et al.. A randomized study of SMS 201-995 versus bromocriptine treatment in acromegaly: clinical and biochemical effects. J Clin Endocrinol Metab. 1990; 70(5) 1254-1261
- 67 Ayuk J, Stewart S E, Stewart P M et al.. Long-term safety and efficacy of depot long-acting somatostatin analogs for the treatment of acromegaly. J Clin Endocrinol Metab. 2002; 87(9) 4142-4146
- 68 Colao A, Ferone D, Marzullo P et al.. Long-term effects of depot long-acting somatostatin analog octreotide on hormone levels and tumor mass in acromegaly. J Clin Endocrinol Metab. 2001; 86(6) 2779-2786
- 69 Schoof E, Dorr H G, Kiess W et al.. Five-year follow-up of a 13-year-old boy with a pituitary adenoma causing gigantism-effect of octreotide therapy. Horm Res. 2004; 61(4) 184-189
- 70 Lado-Abeal J, Rodriguez-Arnao J, Newell-Price J D et al.. Menstrual abnormalities in women with Cushing's disease are correlated with hypercortisolemia rather than raised circulating androgen levels. J Clin Endocrinol Metab. 1998; 83(9) 3083-3088
- 71 Cunningham S K, McKenna T J. Dissociation of adrenal androgen and cortisol secretion in Cushing's syndrome. Clin Endocrinol (Oxf). 1994; 41(6) 795-800
- 72 Ahima R S, Harlan R E. Glucocorticoid receptors in LHRH neurons. Neuroendocrinology. 1992; 56(6) 845-850
- 73 Chrousos G P, Schuermeyer T H, Doppman J et al.. NIH conference. Clinical applications of corticotropin-releasing factor. Ann Intern Med. 1985; 102(3) 344-358
- 74 Fukata J, Nakai Y, Imura H et al.. Human corticotropin-releasing hormone test in normal subjects and patients with hypothalamic, pituitary or adrenocortical disorders. Endocrinol Jpn. 1988; 35(3) 491-502
- 75 Kalgikar A M, Chandratreya S A, Goel A et al.. Inferior petrosal sinus sampling in the diagnostic evaluation of Cushing's syndrome: K.E.M. experience. J Assoc Physicians India. 2005; 53 685-688
- 76 Booth G L, Redelmeier D A, Grosman H et al.. Improved diagnostic accuracy of inferior petrosal sinus sampling over imaging for localizing pituitary pathology in patients with Cushing's disease. J Clin Endocrinol Metab. 1998; 83(7) 2291-2295
- 77 Findling J W, Tyrrell J B. Occult ectopic secretion of corticotropin. Arch Intern Med. 1986; 146(5) 929-933
- 78 Landolt A M, Valavanis A, Girard J et al.. Corticotrophin-releasing factor-test used with bilateral, simultaneous inferior petrosal sinus blood-sampling for the diagnosis of pituitary-dependent Cushing's disease. Clin Endocrinol (Oxf). 1986; 25(6) 687-696
- 79 Tindall G T, Herring C J, Clark R V et al.. Cushing's disease: results of transsphenoidal microsurgery with emphasis on surgical failures. J Neurosurg. 1990; 72(3) 363-369
- 80 Mampalam T J, Tyrrell J B, Wilson C B. Transsphenoidal microsurgery for Cushing disease. A report of 216 cases. Ann Intern Med. 1988; 109(6) 487-493
- 81 Semple P L, Vance M L, Findling J W et al.. Transsphenoidal surgery for Cushing's disease: outcome in patients with a normal magnetic resonance imaging scan. Neurosurgery. 2000; 46(3) 553-558
- 82 Kurosaki M, Luedecke D K, Knappe U J et al.. The value of intraoperative cytology during transsphenoidal surgery for ACTH-secreting microadenoma. Acta Neurochir (Wien). 2000; 142(8) 865-870
- 83 Esposito F, Dusick J R, Cohan P et al.. Clinical review: early morning cortisol levels as a predictor of remission after transsphenoidal surgery for Cushing's disease. J Clin Endocrinol Metab. 2006; 91(1) 7-13
- 84 Nakane T, Kuwayama A, Watanabe M et al.. Long term results of transsphenoidal adenomectomy in patients with Cushing's disease. Neurosurgery. 1987; 21(2) 218-222
- 85 Shimon I, Ram Z, Cohen Z R et al.. Transsphenoidal surgery for Cushing's disease: endocrinological follow-up monitoring of 82 patients. Neurosurgery. 2002; 51(1) 57-61
- 86 Chaidarun S S, Klibanski A. Gonadotropinomas. Semin Reprod Med. 2002; 20(4) 339-348
- 87 Samuels M H, Ridgway E C. Glycoprotein-secreting pituitary adenomas. Baillieres Clin Endocrinol Metab. 1995; 9(2) 337-358
- 88 Klibanski A. Nonsecreting pituitary tumors. Endocrinol Metab Clin North Am. 1987; 16(3) 793-804
- 89 Jameson J L, Klibanski A, Black P M et al.. Glycoprotein hormone genes are expressed in clinically nonfunctioning pituitary adenomas. J Clin Invest. 1987; 80(5) 1472-1478
- 90 Yamada S, Asa S L, Kovacs K et al.. Analysis of hormone secretion by clinically nonfunctioning human pituitary adenomas using the reverse hemolytic plaque assay. J Clin Endocrinol Metab. 1989; 68(1) 73-80
- 91 Hanson P L, Aylwin S J, Monson J P et al.. FSH secretion predominates in vivo and in vitro in patients with non-functioning pituitary adenomas. Eur J Endocrinol. 2005; 152(3) 363-370
- 92 Ghayuri M, Liu J H. Ovarian hyperstimulation syndrome caused by pituitary gonadotroph adenoma secreting follicle-stimulating hormone. Obstet Gynecol. 2007; 109(2 pt2) 547-549
- 93 Shimon I, Rubinek T, Bar-Hava I et al.. Ovarian hyperstimulation without elevated serum estradiol associated with pure follicle-stimulating hormone-secreting pituitary adenoma. J Clin Endocrinol Metab. 2001; 86(8) 3635-3640
- 94 Kihara M, Sugita T, Nagai Y et al.. Ovarian hyperstimulation caused by gonadotroph cell adenoma: a case report and review of the literature. Gynecol Endocrinol. 2006; 22(2) 110-113
- 95 Tashiro H, Katabuchi H, Ohtake H et al.. A follicle-stimulating hormone-secreting gonadotroph adenoma with ovarian enlargement in a 10-year-old girl. Fertil Steril. 1999; 72(1) 158-160
- 96 Roberts J E, Spandorfer S, Fasouliotis S J et al.. Spontaneous ovarian hyperstimulation caused by a follicle-stimulating hormone-secreting pituitary adenoma. Fertil Steril. 2005; 83(1) 208-210
- 97 Ambrosi B, Bassetti M, Ferrario R et al.. Precocious puberty in a boy with a PRL-, LH- and FSH-secreting pituitary tumour: hormonal and immunocytochemical studies. Acta Endocrinol (Copenh). 1990; 122(5) 569-576
- 98 Faggiano M, Criscuolo T, Perrone L et al.. Sexual precocity in a boy due to hypersecretion of LH and prolactin by a pituitary adenoma. Acta Endocrinol (Copenh). 1983; 102(2) 167-172
- 99 Cook D M, Watkins S, Snyder P J. Gonadotrophin-secreting pituitary adenomas masquerading as primary ovarian failure. Clin Endocrinol (Oxf). 1986; 25(6) 729-738
- 100 Somjen D, Tordjman K, Kohen F et al.. Combined beta FSH and beta LH response to TRH in patients with clinically non-functioning pituitary adenomas. Clin Endocrinol (Oxf). 1997; 46(5) 555-562
- 101 Lamberts S W, Verleun T, Oosterom R et al.. The effects of bromocriptine, thyrotropin-releasing hormone, and gonadotropin-releasing hormone on hormone secretion by gonadotropin-secreting pituitary adenomas in vivo and in vitro. J Clin Endocrinol Metab. 1987; 64(3) 524-530
- 102 White M C, Daniels M, Newland P et al.. LH and FSH secretion and responses to GnRH and TRH in patients with clinically functionless pituitary adenomas. Clin Endocrinol (Oxf). 1990; 32(6) 681-688
- 103 Chanson P, Schaison G. Pituitary apoplexy caused by GnRH-agonist treatment revealing gonadotroph adenoma. J Clin Endocrinol Metab. 1995; 80(7) 2267-2268
- 104 Frankart L, De Hertogh R, Donckier J et al.. Pituitary apoplexy of a gonadotrophinoma and TRH/GnRH tests. Literature review. Acta Clin Belg. 1995; 50(3) 163-170
- 105 Shomali M E, Katznelson L. Medical therapy of gonadotropin-producing and nonfunctioning pituitary adenomas. Pituitary. 2002; 5(2) 89-98
- 106 Sassolas G, Lejeune H, Trouillas J et al.. Gonadotropin-releasing hormone agonists are unsuccessful in reducing tumoral gonadotropin secretion in two patients with gonadotropin-secreting pituitary adenomas. J Clin Endocrinol Metab. 1988; 67(1) 180-185
- 107 McGrath G A, Goncalves R J, Udupa J K et al.. New technique for quantitation of pituitary adenoma size: use in evaluating treatment of gonadotroph adenomas with a gonadotropin-releasing hormone antagonist. J Clin Endocrinol Metab. 1993; 76(5) 1363-1368
- 108 Beck-Peccoz P, Brucker-Davis F, Persani L et al.. Thyrotropin-secreting pituitary tumors. Endocr Rev. 1996; 17(6) 610-638
- 109 Southren A L, Olivo J, Gordon G G et al.. The conversion of androgens to estrogens in hyperthyroidism. J Clin Endocrinol Metab. 1974; 38(2) 207-214
- 110 Akande E O, Hockaday T D. Plasma concentration of gonadotrophins, oestrogens and progesterone in thyrotoxic women. Br J Obstet Gynaecol. 1975; 82(7) 541-551
- 111 Kalro B N. Impaired fertility caused by endocrine dysfunction in women. Endocrinol Metab Clin North Am. 2003; 32(3) 573-592
- 112 Beck-Peccoz P, Persani L. Medical management of thyrotropin-secreting pituitary adenomas. Pituitary. 2002; 5(2) 83-88
- 113 Kourides I A, Ridgway E C, Weintraub B D et al.. Thyrotropin-induced hyperthyroidism: use of alpha and beta subunit levels to identify patients with pituitary tumors. J Clin Endocrinol Metab. 1977; 45(3) 534-543
- 114 Beck-Peccoz P, Persani L, Faglia G. Glycoprotein hormone alpha-subunit in pituitary-adenomas. Trends Endocrinol Metab. 1992; 3(2) 41-45
- 115 Bertherat J, Brue T, Enjalbert A et al.. Somatostatin receptors on thyrotropin-secreting pituitary adenomas: comparison with the inhibitory effects of octreotide upon in vivo and in vitro hormonal secretions. J Clin Endocrinol Metab. 1992; 75(2) 540-546
- 116 Kuhn J M, Arlot S, Lefebvre H et al.. Evaluation of the treatment of thyrotropin-secreting pituitary adenomas with a slow release formulation of the somatostatin analog lanreotide. J Clin Endocrinol Metab. 2000; 85(4) 1487-1491
- 117 Caron P, Arlot S, Bauters C et al.. Efficacy of the long-acting octreotide formulation (octreotide-LAR) in patients with thyrotropin-secreting pituitary adenomas. J Clin Endocrinol Metab. 2001; 86(6) 2849-2853
- 118 Fischler M P, Reinhart W H. TSH-secreting pituitary macroadenoma: rapid tumor shrinkage and recovery from hyperthyroidism with octreotide. J Endocrinol Invest. 1999; 22(1) 64-65
- 119 Faglia G, Beck-Peccoz P, Piscitelli G et al.. Inappropriate secretion of thyrotropin by the pituitary. Horm Res. 1987; 26(1-4) 79-99
- 120 Wollesen F, Andersen T, Karle A. Size reduction of extrasellar pituitary tumors during bromocriptine treatment. Ann Intern Med. 1982; 96(3) 281-286
Lisa M HalvorsonM.D.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Texas Medical Center at Dallas
5323 Harry Hines Blvd., J6-114, Dallas, TX 75390
Email: Lisa.Halvorson@UTSouthwestern.edu