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Published in: Pituitary 3/2008

01-09-2008 | Case Report

Pituitary apoplexy during treatment of cystic macroprolactinomas with cabergoline

Authors: Giovanna Aparecida Balarini Lima, Evelyn de Oliveira Machado, Cintia Marques dos Santos Silva, Paulo Niemeyer Filho, Mônica Roberto Gadelha

Published in: Pituitary | Issue 3/2008

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Abstract

Pituitary apoplexy is a rare and life-threatening clinical condition caused by hemorrhage and/or infarction of the pituitary gland or adenoma. Although pituitary apoplexy is usually spontaneous, it has been associated with numerous precipitating factors, such as bromocriptine use. However, reports of pituitary apoplexy during cabergoline therapy are scarce. We report three patients with cystic macroprolactinomas who developed pituitary apoplexy during cabergoline treatment.
Literature
1.
go back to reference Brougham M, Heusner AP, Adams RD (1950) Acute degenerative changes in adenomas of the pituitary body – with special reference to pituitary apoplexy. J Neurosurg 7:421–439PubMed Brougham M, Heusner AP, Adams RD (1950) Acute degenerative changes in adenomas of the pituitary body – with special reference to pituitary apoplexy. J Neurosurg 7:421–439PubMed
2.
go back to reference Rovit RL, Fein JM (1972) Pituitary apoplexy: a review and repraisal. J Neurosurg 37:280–288PubMed Rovit RL, Fein JM (1972) Pituitary apoplexy: a review and repraisal. J Neurosurg 37:280–288PubMed
3.
go back to reference Mohr G, Hardy J (1982) Hemorrhage, necrosis, and apoplexy in pituitary adenomas. Surg Neurol 18:181–189PubMedCrossRef Mohr G, Hardy J (1982) Hemorrhage, necrosis, and apoplexy in pituitary adenomas. Surg Neurol 18:181–189PubMedCrossRef
4.
go back to reference Rolih CA, Ober KP (1993) Pituitary apoplexy. Endocrinol Metab Clin N Am 22:291–302 Rolih CA, Ober KP (1993) Pituitary apoplexy. Endocrinol Metab Clin N Am 22:291–302
5.
go back to reference Bonicki W, Kasperlik-Zaluska A, Koszewski W, Zgliczynski W, Wislawski J (1993) Pituitary apoplexy: endocrine, surgical and oncological emergency Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas. Acta Neurochir (Wien) 120:118–122CrossRef Bonicki W, Kasperlik-Zaluska A, Koszewski W, Zgliczynski W, Wislawski J (1993) Pituitary apoplexy: endocrine, surgical and oncological emergency Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas. Acta Neurochir (Wien) 120:118–122CrossRef
6.
go back to reference Pinheiro MM, Cukiert A, Salgado LR, Nery M, Goldman J, Pimentel F, Liberman B (1999) Asymptomatic apoplexy in pituitary tumors. Arq Neuro-Psiquiat 57:74–77 Pinheiro MM, Cukiert A, Salgado LR, Nery M, Goldman J, Pimentel F, Liberman B (1999) Asymptomatic apoplexy in pituitary tumors. Arq Neuro-Psiquiat 57:74–77
7.
go back to reference Tamasawa N, Kurahashi K, Baba T, Hishita R, Murabayashi S, Kashiwamura H, Takebe K (1988) Spontaneous remission of acromegaly after pituitary apoplexy following head trauma. J Endocrinol Invest 11:429–432PubMed Tamasawa N, Kurahashi K, Baba T, Hishita R, Murabayashi S, Kashiwamura H, Takebe K (1988) Spontaneous remission of acromegaly after pituitary apoplexy following head trauma. J Endocrinol Invest 11:429–432PubMed
8.
go back to reference Reid RL, Quigley ME, Yen SS (1985) Pituitary apoplexy. A review. Arch Neurol 42:712–719PubMed Reid RL, Quigley ME, Yen SS (1985) Pituitary apoplexy. A review. Arch Neurol 42:712–719PubMed
9.
go back to reference Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA (1999) Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol (Oxf) 51:181–188CrossRef Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA (1999) Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol (Oxf) 51:181–188CrossRef
10.
go back to reference Eisberg LA (1977) Pituitary apoplexy. Association of degenerative change in pituitary adenoma with radiotherapy and detection by cerebral computed tomography. Am J Med 63:109–115CrossRef Eisberg LA (1977) Pituitary apoplexy. Association of degenerative change in pituitary adenoma with radiotherapy and detection by cerebral computed tomography. Am J Med 63:109–115CrossRef
11.
go back to reference Otsuka F, Kageyama J, Ogura T, Makino H (1998) Pituitary apoplexy induced by a combined anterior pituitary test: case report and review of the literature. Endocr J 45:393–398PubMedCrossRef Otsuka F, Kageyama J, Ogura T, Makino H (1998) Pituitary apoplexy induced by a combined anterior pituitary test: case report and review of the literature. Endocr J 45:393–398PubMedCrossRef
12.
go back to reference Levy A (2003) Hazards of dynamic testing of pituitary function. Clin Endocrinol (Oxf) 58:543–544CrossRef Levy A (2003) Hazards of dynamic testing of pituitary function. Clin Endocrinol (Oxf) 58:543–544CrossRef
13.
go back to reference Alzetani A, Fisher C, Costa R, Ohri SK (2002) Ptose postcardiac surgery: a case of pituitary apoplexy. Ann Thorac Surg 73:300–301PubMedCrossRef Alzetani A, Fisher C, Costa R, Ohri SK (2002) Ptose postcardiac surgery: a case of pituitary apoplexy. Ann Thorac Surg 73:300–301PubMedCrossRef
14.
go back to reference Maiza JC, Bennet A, Thom-Kany M, Lagarrigue J, Caron P (2004) Pituitary apoplexy and idiopathic thrombocytopenic purpura: a new case and review of the literature. Pituitary 7:189–192PubMedCrossRef Maiza JC, Bennet A, Thom-Kany M, Lagarrigue J, Caron P (2004) Pituitary apoplexy and idiopathic thrombocytopenic purpura: a new case and review of the literature. Pituitary 7:189–192PubMedCrossRef
15.
go back to reference Nagarajan DV, Bird D, Papouchado M (2003) Pituitary apoplexy following anticoagulation for acute coronary syndrome. Heart 89:10PubMedCrossRef Nagarajan DV, Bird D, Papouchado M (2003) Pituitary apoplexy following anticoagulation for acute coronary syndrome. Heart 89:10PubMedCrossRef
16.
go back to reference Yamaji T, Ishibashi M, Kosaka K, Fukushima T, Hori T, Manaka S, Sano K (1981) Pituitary apoplexy in acromegaly during bromocriptine therapy. Acta Endocrinol (Copenh) 98:171–177 Yamaji T, Ishibashi M, Kosaka K, Fukushima T, Hori T, Manaka S, Sano K (1981) Pituitary apoplexy in acromegaly during bromocriptine therapy. Acta Endocrinol (Copenh) 98:171–177
17.
go back to reference Shirataki K, Chihara K, Shibata Y, Tamaki N, Matsumono S, Fujita T (1988) Pituitary apoplexy manifested during a bromocriptine test in a patient with a growth hormone- and prolactin-producing pituitary adenoma. Neurosurgery 23:395–398PubMedCrossRef Shirataki K, Chihara K, Shibata Y, Tamaki N, Matsumono S, Fujita T (1988) Pituitary apoplexy manifested during a bromocriptine test in a patient with a growth hormone- and prolactin-producing pituitary adenoma. Neurosurgery 23:395–398PubMedCrossRef
18.
go back to reference Alhajje A, Lambert M, Crabbe J (1985) Pituitary apoplexy in an acromegalic patient during bromocriptine therapy. Case report. J Neurosurg 63:288–292PubMed Alhajje A, Lambert M, Crabbe J (1985) Pituitary apoplexy in an acromegalic patient during bromocriptine therapy. Case report. J Neurosurg 63:288–292PubMed
19.
go back to reference Pinto G, Zerah M, Trivin C, Brauner R (1998) Pituitary apoplexy in an adolescent with prolactin-secreting adenoma. Horm Res 50:38–41PubMedCrossRef Pinto G, Zerah M, Trivin C, Brauner R (1998) Pituitary apoplexy in an adolescent with prolactin-secreting adenoma. Horm Res 50:38–41PubMedCrossRef
20.
21.
go back to reference Yahagi N, Nishikawa A, Matsui S, Komoda Y, Sai Y, Amakata Y (1992) Pituitary apoplexy following cholecystectomy. Anaesthesia 47:234–236PubMedCrossRef Yahagi N, Nishikawa A, Matsui S, Komoda Y, Sai Y, Amakata Y (1992) Pituitary apoplexy following cholecystectomy. Anaesthesia 47:234–236PubMedCrossRef
22.
go back to reference Molitch ME, Elton RL, Blackwell RE, Caldwell B, Chang RJ, Jaffe R, Joplin G, Robbins RJ, Tyson J, Thorner MO (1985) Bromocriptine as primary medical therapy for prolactin-secreting macroadenomas: results of a prospective multicenter study. J Clin Endocrinol Metab 60:698–705PubMed Molitch ME, Elton RL, Blackwell RE, Caldwell B, Chang RJ, Jaffe R, Joplin G, Robbins RJ, Tyson J, Thorner MO (1985) Bromocriptine as primary medical therapy for prolactin-secreting macroadenomas: results of a prospective multicenter study. J Clin Endocrinol Metab 60:698–705PubMed
23.
go back to reference Molitch ME (1999) Medical treatment of prolactinomas. Endocrinol Metab Clin N Am 28:143–169CrossRef Molitch ME (1999) Medical treatment of prolactinomas. Endocrinol Metab Clin N Am 28:143–169CrossRef
24.
go back to reference Bevan JS, Webster J, Christopher WB (1992) Dopamin agonist and pituitary tumor shrinkage. Endocr Rev 13:220–240PubMedCrossRef Bevan JS, Webster J, Christopher WB (1992) Dopamin agonist and pituitary tumor shrinkage. Endocr Rev 13:220–240PubMedCrossRef
25.
go back to reference Pellegrini I, Rasolonjanahary R, Gunz G, Bertrand P, Delivet CP, Jedynak CP, Kordon C, Peillon F, Jaquet P, Enjalbert A (1989) Resistance to bromocriptine in prolactinomas. J Clin Endocrinol Metab 69:500–509PubMed Pellegrini I, Rasolonjanahary R, Gunz G, Bertrand P, Delivet CP, Jedynak CP, Kordon C, Peillon F, Jaquet P, Enjalbert A (1989) Resistance to bromocriptine in prolactinomas. J Clin Endocrinol Metab 69:500–509PubMed
26.
go back to reference Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF (1994) for the Cabergoline Comparative Study Group. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. N Engl J Med 331:904–909PubMedCrossRef Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF (1994) for the Cabergoline Comparative Study Group. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. N Engl J Med 331:904–909PubMedCrossRef
27.
go back to reference Colao A, Di Sarno A, Sarnacchiaro F, Ferone D, Di Renzo G, Merola B, Annunziato L, Lombardi G (1997) Prolactinomas resistant to dopamine agonists respond to chronic cabergoline treatment. J Clin Endocrinol Metab 82:876–883PubMedCrossRef Colao A, Di Sarno A, Sarnacchiaro F, Ferone D, Di Renzo G, Merola B, Annunziato L, Lombardi G (1997) Prolactinomas resistant to dopamine agonists respond to chronic cabergoline treatment. J Clin Endocrinol Metab 82:876–883PubMedCrossRef
28.
go back to reference Verhelst J, Abs R, Maiter D, van den Bruel A, Vandeweghe M, Velkeniers B, Mockel J, Lamberigts G, Petrossians P, Coremans P, Mahler C, Stevenaert A, Verlooy J, Raftopoulos C, Beckers A (1999) Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients. J Clin Endocrinol Metab 84:2518–2522PubMedCrossRef Verhelst J, Abs R, Maiter D, van den Bruel A, Vandeweghe M, Velkeniers B, Mockel J, Lamberigts G, Petrossians P, Coremans P, Mahler C, Stevenaert A, Verlooy J, Raftopoulos C, Beckers A (1999) Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients. J Clin Endocrinol Metab 84:2518–2522PubMedCrossRef
29.
go back to reference Biller BM, Molitch ME, Vance ML, Cannistraro KB, Davis KR, Simons JA, Schoenfelder JR, Klibanski A (1996) Treatment of prolactin-secreting macroadenomas with the once-weekly dopamine agonist cabergoline. J Clin Endocrinol Metab 81:2338–2343PubMedCrossRef Biller BM, Molitch ME, Vance ML, Cannistraro KB, Davis KR, Simons JA, Schoenfelder JR, Klibanski A (1996) Treatment of prolactin-secreting macroadenomas with the once-weekly dopamine agonist cabergoline. J Clin Endocrinol Metab 81:2338–2343PubMedCrossRef
30.
go back to reference Knoepfelmacher M, Gomes MC, Melo ME, Mendonça BB (2004) Pituitary apoplexy during therapy with cabergoline in an adolescent male with prolactin-secreting macroadenoma. Pituitary 7:83–87PubMedCrossRef Knoepfelmacher M, Gomes MC, Melo ME, Mendonça BB (2004) Pituitary apoplexy during therapy with cabergoline in an adolescent male with prolactin-secreting macroadenoma. Pituitary 7:83–87PubMedCrossRef
31.
go back to reference Ebersold MJ, Laws ERJr, Scheithauer BW, Randall RV (1983) Pituitary apoplexy treated by transsphenoidal surgery. A clinicopathological and immunocytochemical study. J Neurosurg 58:315–320PubMed Ebersold MJ, Laws ERJr, Scheithauer BW, Randall RV (1983) Pituitary apoplexy treated by transsphenoidal surgery. A clinicopathological and immunocytochemical study. J Neurosurg 58:315–320PubMed
32.
go back to reference Arafah BM, Harrington JF, Madhoun ZT, Selman WR (1990) Improvement of pituitary function after surgical decompression for pituitary tumor apoplexy. J Clin Endocrinol Metab 71:323–328PubMed Arafah BM, Harrington JF, Madhoun ZT, Selman WR (1990) Improvement of pituitary function after surgical decompression for pituitary tumor apoplexy. J Clin Endocrinol Metab 71:323–328PubMed
33.
go back to reference Bills DC, Meyer FB, Laws ER Jr, Davis DH, Ebersold MJ, Scheithauer BW, Ilstrup DM, Abboud CF (1993) A retrospective analysis of pituitary apoplexy. Neurosurgery 33:602–608PubMedCrossRef Bills DC, Meyer FB, Laws ER Jr, Davis DH, Ebersold MJ, Scheithauer BW, Ilstrup DM, Abboud CF (1993) A retrospective analysis of pituitary apoplexy. Neurosurgery 33:602–608PubMedCrossRef
34.
go back to reference Maccagnan P, Macedo CL, Kayath MJ, Nogueira RG, Abucham J (1995) Conservative management of pituitary apoplexy: a prospective study. J Clin Endocrinol Metab 80:2190–2197PubMedCrossRef Maccagnan P, Macedo CL, Kayath MJ, Nogueira RG, Abucham J (1995) Conservative management of pituitary apoplexy: a prospective study. J Clin Endocrinol Metab 80:2190–2197PubMedCrossRef
35.
go back to reference Ayuk J, McGregor EJ, Mitchell RD, Gittoes NJL (2004) Acute management of pituitary apoplexy – surgery or conservative management? Clin Endocrinol (Oxf) 61:747–752CrossRef Ayuk J, McGregor EJ, Mitchell RD, Gittoes NJL (2004) Acute management of pituitary apoplexy – surgery or conservative management? Clin Endocrinol (Oxf) 61:747–752CrossRef
36.
go back to reference Wakai S, Fukushima T, Teramoto A, Sano K (1981) Pituitary apoplexy: its incidence and clinical significance. J Neurosurg 55:187–193PubMed Wakai S, Fukushima T, Teramoto A, Sano K (1981) Pituitary apoplexy: its incidence and clinical significance. J Neurosurg 55:187–193PubMed
38.
go back to reference Enjalbert A, Bockaert J (1983) Pharmacological characterization of D2 dopamine receptor negatively coupled with adenylate cyclase in rat anterior pituitary. Mol Pharmacol 23:576–584PubMed Enjalbert A, Bockaert J (1983) Pharmacological characterization of D2 dopamine receptor negatively coupled with adenylate cyclase in rat anterior pituitary. Mol Pharmacol 23:576–584PubMed
39.
go back to reference De Camille P, Macconi P, Spada A (1979) Dopamine inhibits adenylate cyclase in human prolactin-secreting pituitary adenomas. Nature 278:252–254CrossRef De Camille P, Macconi P, Spada A (1979) Dopamine inhibits adenylate cyclase in human prolactin-secreting pituitary adenomas. Nature 278:252–254CrossRef
40.
go back to reference Brocas H, Van Coevorden A, Seo H, Refetoff S, Vassart G (1981) Dopaminergic control of prolactin mRNA accumulation in the pituitary of the male rat. Mol Cell Endocrinol 22:25–30PubMedCrossRef Brocas H, Van Coevorden A, Seo H, Refetoff S, Vassart G (1981) Dopaminergic control of prolactin mRNA accumulation in the pituitary of the male rat. Mol Cell Endocrinol 22:25–30PubMedCrossRef
41.
go back to reference Maurer RA (1981) Transcriptional regulation of the prolactin gene by ergocryptine and cyclic AMP. Nature 294:94–97PubMedCrossRef Maurer RA (1981) Transcriptional regulation of the prolactin gene by ergocryptine and cyclic AMP. Nature 294:94–97PubMedCrossRef
42.
go back to reference Shull JD, Gorski J (1990) Regulation of prolactin gene transcription in vivo: interactions between estrogen, pimozide, and alpha-ergocryptine. Mol Pharmacol 37:215–221PubMed Shull JD, Gorski J (1990) Regulation of prolactin gene transcription in vivo: interactions between estrogen, pimozide, and alpha-ergocryptine. Mol Pharmacol 37:215–221PubMed
43.
go back to reference Landolt AM, Minder H, Osterwalder V, Landolt TA (1983) Bromocriptine reduces the size of cells in prolactin-secreting pituitary adenomas. Experientia 39:625–626PubMedCrossRef Landolt AM, Minder H, Osterwalder V, Landolt TA (1983) Bromocriptine reduces the size of cells in prolactin-secreting pituitary adenomas. Experientia 39:625–626PubMedCrossRef
44.
go back to reference Gen M, Uozumi T, Ohta M, Ito A, Kajiwara H, Mori S (1984) Necrotic changes in prolactinomas after long-term administration of bromocriptine. J Clin Endocrinol Metab 59:463–470PubMedCrossRef Gen M, Uozumi T, Ohta M, Ito A, Kajiwara H, Mori S (1984) Necrotic changes in prolactinomas after long-term administration of bromocriptine. J Clin Endocrinol Metab 59:463–470PubMedCrossRef
45.
go back to reference Mori H, Mori S, Saitoh Y, Arita N, Aono T, Uozomi T, Mogami H, Matsumoto K (1985) Effects of bromocriptine on prolactin-secreting pituitary adenomas Mechanism of reduction in tumor cell size evaluated by light and electron microscopic, immunohistochemical, and morphometric analysis. Cancer 56:230–238PubMedCrossRef Mori H, Mori S, Saitoh Y, Arita N, Aono T, Uozomi T, Mogami H, Matsumoto K (1985) Effects of bromocriptine on prolactin-secreting pituitary adenomas Mechanism of reduction in tumor cell size evaluated by light and electron microscopic, immunohistochemical, and morphometric analysis. Cancer 56:230–238PubMedCrossRef
46.
go back to reference Rengachary SS, Tomita T, Jefferies BF, Watanabe I (1982) Structural changes in human pituitary tumor after bromocriptine therapy. Neurosurgery 10:242–251PubMedCrossRef Rengachary SS, Tomita T, Jefferies BF, Watanabe I (1982) Structural changes in human pituitary tumor after bromocriptine therapy. Neurosurgery 10:242–251PubMedCrossRef
47.
go back to reference Tindall GT, Kovacs K, Horvath E, Thorner MO (1982) Human prolactin-producing adenomas and bromocriptine. A histological, immunocytochemical, ultrastructural, and morphometric study. J Clin Endocrinol Metab 55:1178–1183PubMed Tindall GT, Kovacs K, Horvath E, Thorner MO (1982) Human prolactin-producing adenomas and bromocriptine. A histological, immunocytochemical, ultrastructural, and morphometric study. J Clin Endocrinol Metab 55:1178–1183PubMed
48.
go back to reference Barrow DL, Tindall GT, Kovacs K, Thorner MO, Horvarth E, Hoffman JC Jr (1984) Clinical and pathological effects of bromocriptine on prolactin-secreting and other pituitary tumors. J Neurosurg 60:1–7PubMedCrossRef Barrow DL, Tindall GT, Kovacs K, Thorner MO, Horvarth E, Hoffman JC Jr (1984) Clinical and pathological effects of bromocriptine on prolactin-secreting and other pituitary tumors. J Neurosurg 60:1–7PubMedCrossRef
49.
go back to reference Kovacs K, Stefaneanu L, Horvath E, Lloyd RV, Lancranjan I, Buchfelder M, Fahlbusch R (1991) Effect of dopamine agonist medication on prolactin producing pituitary adenomas. A morphological study including immunocytochemistry, electron microscopy and in situ hybridization. Virchows Arch A Pathol Anat Histopathol 418:439–446PubMedCrossRef Kovacs K, Stefaneanu L, Horvath E, Lloyd RV, Lancranjan I, Buchfelder M, Fahlbusch R (1991) Effect of dopamine agonist medication on prolactin producing pituitary adenomas. A morphological study including immunocytochemistry, electron microscopy and in situ hybridization. Virchows Arch A Pathol Anat Histopathol 418:439–446PubMedCrossRef
50.
go back to reference Landolt AM, Osterwalder V (1984) Perivascular necrosis in prolactinomas: is it increased by bromocriptine?. J Clin Endocrinol Metab 58:1179–1183PubMed Landolt AM, Osterwalder V (1984) Perivascular necrosis in prolactinomas: is it increased by bromocriptine?. J Clin Endocrinol Metab 58:1179–1183PubMed
51.
go back to reference Lloyd HM, Meares JD, Jacobi J (1975) Effects of oestrogen and bromocriptine on in vivo secretion and mitosis in prolactin cells. Nature 255:497–498PubMedCrossRef Lloyd HM, Meares JD, Jacobi J (1975) Effects of oestrogen and bromocriptine on in vivo secretion and mitosis in prolactin cells. Nature 255:497–498PubMedCrossRef
52.
go back to reference Kontogeorgos G, Horvath E, Kovacs K, Coire C, Lloyd RV, Scheithauer BW, Smyth HS (2006) Morphologic changes of prolactin-producing pituitary adenomas after short treatment with dopamine agonists. Acta Neuropathol 111:46–52PubMedCrossRef Kontogeorgos G, Horvath E, Kovacs K, Coire C, Lloyd RV, Scheithauer BW, Smyth HS (2006) Morphologic changes of prolactin-producing pituitary adenomas after short treatment with dopamine agonists. Acta Neuropathol 111:46–52PubMedCrossRef
53.
go back to reference Yousem DM, Arrington JA, James Zinhreich S, Kumar AJ, Nick Bryan R (1989) Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage. Radiology 170:239–243PubMed Yousem DM, Arrington JA, James Zinhreich S, Kumar AJ, Nick Bryan R (1989) Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage. Radiology 170:239–243PubMed
54.
go back to reference Lundin P, Nyman R, Burman P, Lundberg PO, Muhr C (1992) MRI of pituitary macroadenomas with reference to hormonal activity. Neuroradiol 34:43–51CrossRef Lundin P, Nyman R, Burman P, Lundberg PO, Muhr C (1992) MRI of pituitary macroadenomas with reference to hormonal activity. Neuroradiol 34:43–51CrossRef
55.
go back to reference Delgrange E, Gustin T (2005) Cystic macroprolactinoma: primary medical treatment? Intern Med J 35:687–688PubMedCrossRef Delgrange E, Gustin T (2005) Cystic macroprolactinoma: primary medical treatment? Intern Med J 35:687–688PubMedCrossRef
Metadata
Title
Pituitary apoplexy during treatment of cystic macroprolactinomas with cabergoline
Authors
Giovanna Aparecida Balarini Lima
Evelyn de Oliveira Machado
Cintia Marques dos Santos Silva
Paulo Niemeyer Filho
Mônica Roberto Gadelha
Publication date
01-09-2008
Publisher
Springer US
Published in
Pituitary / Issue 3/2008
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-007-0046-6

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