Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reported in this paper is the effectiveness of antiprolactinaemic treatment of 40 infertile women. All case histories revealed previous unsuccessful attempts to induce ovulation. Antiprolactinaemic treatment was in all cases preced by RIA determination of prolactin and gonadotrophin. Prolactin levels were found to be somewhat increase in 19 cases, while 21 women were normal. The gonadotrophin plasma levels usually were closer to the lower limits of normal values. The presence of hypophyseal adenoma had been ruled out beforehand. Long-time treatment was based on the administration of 5 mg Parlodel/die. The effect was excellent in all cases of hyperprolactinaemia, but response was recorded, as well, from a group of patients with normal prolactin levels. Galactorrhoea ceased to exist in all cases. Clomiphen was applied again to induce ovulation in those patients who had not responded at all or developed only bleeding without ovulation. That treatment proved to be effective in several cases.
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PMID:[Clinical importance of antiprolactinaemic treatment of functional infertility (author's transl)]. 4 37

The presenting signs, symptoms, roentgenographic findings, endocrine evaluations, treatment, and results in 68 cases of presumed pituitary adenomas treated over an 18-year period are discussed. The most common symptoms were headache, acromegalic changes, visual symptoms, and amenorrhea. Most common physical findings were obesity, acromegaly, and visual field defects, usually bitemporal hemianopsia. Roentgenographic evidence of sellar erosion was almost universal but angiography and pneumoencephalography were required to evaluate suprasellar extension. Brain scan was not considered a particularly useful diagnostic tool. Endocrine status was best evaluated by a battery of tests including 17-OH, 17-KS, T3, T4, PBI, ACTH stimulation, and FSH and STH levels. (Prolactin levels are currently being obtained, also). Surgical specimens were obtained in 29 patients, with subsequent diagnoses of 22 chromophobe adenomas, five eosinophilie adenomas, one cystic adenoma, and one necrotic tumor. All five eosinophilic tumors came from acromegalic patients. Patients treated by operation alone or operation followed by radiotherapy generally had less "medical morbidity" than did patients who received radiotherapy alone.
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PMID:Review of 18 years' experience with pituitary tumors. 19 48

A new pituitary classification has been developed, based on the histologic, histochemical, immunocytologic and electron microscopic investigation of 207 pituitary adenomas removed surgically from male and female patients of various ages and different clinical symptomatology. Based principally on cytogenesis, the classification attempts to correlate the morphologic features of the tumor cells with their secretory activities, the clinical history, symptomatology, and biochemical findings. The classification consists of the following eight entities: 1) growth hormone cell adenoma; 2) prolactin cell adenoma; 3) mixed growth hormone cell-prolactin cell adenoma; 4) acidophil stem cell adenoma; 5) corticotroph cell adenoma; 6) thyrotroph cell adenoma; 7) gonadotroph cell adenoma; 8) undifferentiated cell adenoma, including oncocytoma. Prolactin adenomas were found to be the most frequently occurring pituitary adenoma type.
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PMID:Pathology of pituitary adenomas. 22 5

This review assesses current knowledge of the control of human prolactin secretion, the means of altering it, and therapeutic regimens soon to reach the practitioner. Prolactin secretion appears to be under the control of hypothalamic neurotransmitter cells that stimulate pituitary lactotrophs via the hypothalamic-pituitary portal system, which is modulated by a prolactin-inhibiting factor and possibly a prolactin-releasing factor. Secretion is further modulated by estrogen and thyroid hormones at the pituitary level. Amenorrhea associated with hyperprolactinemia appears to be caused by hypothalamic dysfunction. In attempting to diagnose pituitary microadenomas as the cause of hyperprolactinemia, a thorough endocrine evaluation must be undertaken. Persons evidencing pituitary adenoma show a poor serum prolactin response to thyrotropin-releasing hormone in 70% of the cases, though false positives also occur. Bromergocryptine and 2-chloro-6-methyl-ergoline-8beta-acetonitrile methanesulfonate (Lergotrile, Lilly) have been used to sustain a reduced serum prolactin level, resulting in resumption of menses, ovulation, and pregnancy in patients without overt evidence of microadenoma. For those with adenoma, either surgical removal or radiation therapy is the conservative treatment.
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PMID:Current concepts of prolacting physiology in normal and abnormal conditions. 40 46

A man with normal-sizes testes and a chromophobe adenoma of the pituitary was found to have elevated plasma levels of FSH and prolactin and severe deficiencies of other trophic hormones. Plasma FSH values doubled after administration of LH-releasing hormone but were not suppressed by exogenous testosterone. Prolactin concentrations were increased by TRH and were suppressed by L-dopa. Testicular histology revealed sparse and apparently inactive Leydig cells. Seminiferous tubules and Sertoli cells were well preserved, but there were few late spermatids.
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PMID:An FSH and prolactin-secreting pituitary tumor: pituitary dynamics and testicular histology. 40 77

Prolactin levels were determined during a gonadotropin-induced pregnancy following hypophysectomy for a chromophobe adenoma. Maternal plasma prolactin concentrations did not vary significantly from prepregnancy values throughout gestation, remaining between 25 and 35 ng/ml. Fetal prolactin levels were 55 ng/ml and maternal levels were 29 ng/ml at delivery. Amniotic fluid prolactin concentration was approximately 100 ng/ml. Decidual tissue isolated from the maternal surface of the chorion released significant amounts of prolactin into the medium during a 24-hour incubation. Final concentrations of prolactin in the incubation medium were as high as 196 ng/ml. It is concluded that after hypophysectomy (1) prolactin is present in the maternal circulation during pregnancy, and the concentration does not change significantly throughout gestation; (2) fetal and amniotic fluid prolactin concentrations near term do not differ significantly from those reported for normal pregnancy; and (3) the capacity of the decidua to release prolactin in vitro is not diminished compared with normal term decidua, suggesting a nonpituitary source of amniotic fluid prolactin.
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PMID:Evidence for a nonpituitary source of amniotic fluid prolactin. 42 16

The clinical and endocrine features, and the responses to different treatment modalities, were examined in 56 patients with galactorrhea and/or hyperprolactinemia after a two month to six year follow-up period. A pituitary adenoma was diagnosed in 17 patients. A prolactin-cell adenoma was identified histologically in eight patients. Other etiologic factors were myxedema (two patients), phenothiazine ingestion (six patients) and breast manipulation (four patients). In 27 patients, including three with abnormalities of the sella turcica, no causal factor was found, and their condition was labelled as dysfunctional in origin. Symptoms were preceded by childbirth in 11 patients and by estrogen-progestin contraception in 22; pituitary adenomas were discovered in both groups in approximately the same frequency (30%) as in the over-all study group. Aside from roentgenographic studies, as well as visual field perimetry in a few cases, a serum prolactin level above 100 ng/ml was the only indicator of a pituitary prolactin-cell adenoma. Prolactin-suppression tests (L-DOPA and 2alpha-Br-ergocryptine) were found to be of no value in discriminating between tumoral and dysfunctional conditions. No significant alterations in prolactin levels occurred after water loading irrespective of basal levels or the nature of the pathologic process. Selective pituitary tumor excision (eight patients) was followed by rapid normalization of prolactin levels and disappearance of clinical abnormalities. Conversely, after pituitary irradiation (eight patients), improvement tended to be slower. Treatment of infertility in those patients without an apparent organic lesion was more successful with 2alpha-Br-ergocryptine (three of three) than with clomiphene (two of seven). Pregnancies following the administration of drugs or after surgical treatment were uneventful. Since follow-up resulted in the early diagnosis of pituitary tumors from seven to 56 months after initial investigation, and since no diagnostic tools are currently available which help to discriminate between tumoral and dysfunctional conditions before abnormalities become evident on roentgenograms, prolonged observation of these patients remains essential.
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PMID:Nonpuerperal galactorrhea and hyperprolactinemia. Clinical findings, endocrine features and therapeutic responses in 56 cases. 55 26

Eleven women with secondary amenorrhea associated with hyperprolactinemia were studied. Base line evaluations, visual field determinations, and routine sella turcica x-rays were normal. Prolactin-secreting pituitary microadenomas were found in all of the patients only after further diagnostic studies were carried out. These studies included polytomography of the sella turcica; dynamic pituitary testing of growth hormone reserve, adrenocorticotropic hormone reserve, and gonadotropin reserve; and prolactin suppression with L-dopa. The early diagnosis of a small prolactin-secreting adenoma may be possible if several diagnostic criteria are utilized. The most sensitive diagnostic indices available are (1) polytomography, (2) the magnitude of the plasma prolactin elevation, and (3) the failure to suppress prolactin secretion with L-dopa. Our findings emphasize the importance of an extensive evaluation of all women with amenorrhea associated with hyperprolactinemia.
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PMID:Prolactin-secreting pituitary microadenoma: detection and evaluation. 64 47

In order to assess the frequency of hyperprolactinaemia in patients with "functionless" pituitary tumours, serum prolactin concentrations have been measured (by radioimmunoassay) in 111 patients with enlargement of the sella turcica who do not have acromegaly, Cushing's syndrome or Nelson's syndrome. The diagnosis of a chromophobe adenoma was confirmed in 76 patients who underwent surgery and was presumptive in the remaining 35. 45 of 64 (70%) patients studied before treatment and 15 of 47 assessed only after pituitary surgery had hyperprolactinaemia. Patients with raised prolactin levels usually presented with amenorrhoea or impotence, whereas reproductive disorders were rare in normoprolactinaemic patients. In many cases the presence of an underlying pituitary tumour was not initially suspected. The results of pituitary surgery were assessed in 25 patients with a chromophobe adenoma; of the 21 hyperprolactinaemic patients, surgery was most successful in those who had a small tumour treated by transsphenoidal adenomectomy. In conclusion, chromophobe adenomas formerly described as "functionless" are commonly associated with hypersecretion of prolactin and the hyperprolactinaemic patients frequently present with amenorrhoea or impotence. Prolactin levels should be measured in all patients with AMENORRHOEA or impotence and in patients with known (or suspected) pituitary tumours, before or after pituitary surgery.
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PMID:Prolactin secretion in patients with chromophobe adenomas of the pituitary: incidence and presentation of hyperprolactinaemia: results of surgical treatment. 71 18

A study of the secretion of prolactin and plasma gonadotrophins was carried out comparatively in 3 groups of patients: histologically confirmed prolactin adenoma (group 1), idiopathic or iatrogenic amenorrhoea/galactorrhoea syndrome (group 2), empty sella turcica syndrome (group 3). The last group differs fundamentally from the two previous by the presence of a normal basal LH and FSH levels and normal LH-RH stimulation. Prolactin is not increased. It may be suppressed by L-dopa and stimulated by TRH. There exist no differences, apart from neuroradiological criteria, between the other two groups. The level of LH is slightly decreased but the response to LRH is positive, this effect often being more clear on FSH. Prolactin levels are raised, this no doubt explaining the negative response to TRH and chlorpromazine stimulation. Suppression by L-dopa is positiive, reflecting the absence of autonomy of prolactin adenomata. The water load test is unsatisfactory. There exists at the present time no method sufficiently discriminating to exclude the presence of a tumour at the origin of an amenorrhoea-galactorrhoea syndrome.
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PMID:[ Study of prolactin and blood gonadotropins in amenorrheas-galactorrhea. Dynamic exploation in 13 cases]. 80 17


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