Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0598934 (tumor growth)
 58,965 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With the advent of the prolactin radioimmunoassay and more sensitive methods of roentgenologic examination, prolactin-secreting pituitary tumors are now being diagnosed with much greater frequency. Definitive treatment has been considered to involve transphenoidal hypophysectomy. The symptoms of hyperprolactinemia including amenorrhea, galactorrhea and infertility can usually be controlled without difficulty by bromergocryptine therapy, but little is known regarding continued tumor growth. Bromergocryptine and other ergot alkaloids have been shown to decrease the production of prolactin and to inhibit the rate of pituitary tumor growth in animal studies. In man, evidence for a similar effect is not as clear. The present study demonstrates tumor regression associated with bromergocryptine therapy in two patients.
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PMID:Regression of pituitary tumors, a possible effect of bromergocryptine. 43 74

Thyroid-stimulating hormone and prolactin (PRL) were measured in 149 women with galactorrhea; 3 were found to have primary hypothyroidism. In the remaining 146, the PRL assay was correlated with menstrual history and results of hypocycloidal polytomography. 14 of 15 patients with PRL levels greater than 200ng/ml had abnormal tomograms. Almost 70% of patients with secondary amenorrhea and low estrogen status had abnormal X-rays. Differentiation among patients with normal or abnormal tomograms based on serum PRL level in patients with oligomenorrhea and secondary amenorrhea with normal estrogen status was not possible. A medical panel discussion of the study's design and results focuses on high level radiation exposure during diagnosis and the relationship of oral contraceptive (OC) use to galactorrhea, including temporal correlation between time of ingestion and onset of symptoms. Galactorrhea has been associated with prior use of OCs, but this study gives no data due to the lack of reliable OC-use history by many of the patients. Thyroid surgery is recommended for women wishing fertility because pregnancy could stimulate tumor growth and cause sudden blindness.
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PMID:The significance of galactorrhea in patients with normal menses, oligomenorrhea, and secondary amenorrhea. 56 42

Fifty-one female patients with prolactin producing tumors (PRL 1100 to 88,000 microU/ml) and 26 male patients with prolactin producing tumors (PRL 6500 to 400,000 microU/ml) were studied. Only 25% of the females had visual field defects which were present in 70% of the males. All females had amenorrhea but only 35 had galactorrhea. Hypopituitarism was rarely seen in the females but in most of the male patients. Twenty-four females and all male patients were operated (transphenoidal or transfrontal operation). PRL normalized in only eight females and in none of the males. Two patients became pregnant postoperatively, four after postoperative treatment with bromocriptine. Bromocriptine induced regular menses in 4 other patients operated by transsphenoidal route. Eight patients with microadenoma (PRL less than 4000 microU/ml) were treated with bromocriptine alone of whom two became pregnant. The males were also treated with bromocriptine leading to a significant fall of the PRL level accompanied by improvement of libido, sexual potency and headache. Two patients received radiation postoperatively, which led to a fall of PRL and improvement of visual fields. Since PRL levels remained low after withdrawal of bromocriptine for several months an antiproliferative effect of this drug is suggested. Thus differential therapy of PRL producing tumors is possible: In females selective neurosurgery can alone or combined with medical therapy normalize PRL secretion and ovarian function. In patients with microadenoma bromocriptine alone can be successful. In patients with inoperable large tumors radiation should be advocated. Additional bromocriptine therapy may be helpful to stop tumor growth and alleviate the effects of hyperprolactinemia.
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PMID:Treatment of patients with prolactinomas. 75 42

Marginal elevations in serum PRL concentration represent a particularly difficult diagnostic dilemma. In most cases, mild hyperprolactinemia is not associated with organic disease. Patients with menstrual disturbances, galactorrhea, and confirmed elevations in serum PRL should have a screening TSH to rule out primary hypothyroidism (5). In cases where there is no clear etiology of hyperprolactinemia, an MRI should be performed. Magnetic resonance imaging with gadolinium is more sensitive and specific than CT scanning in detecting all types of pituitary tumors and is the study of choice (4). Further, a serum IGF-1 level (or OGTT) should be obtained when clinical symptoms and/or a pituitary mass suggest the possibility of acromegaly. An individual with abnormal GH screening tests but an unremarkable MRI would be subjected to an especially careful follow-up, including IGF-1 and PRL levels every 6 to 12 months. In this way, early tumor growth may be detected making a surgical cure more likely (Fig. 1). Although we have stressed the importance of GH-producing tumors as a cause of hyperprolactinemia, other tumor types of the pituitary may do so as well. Most of these will be detected by MRI.
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PMID:Marginally elevated prolactin levels require magnetic resonance imaging and evaluation for acromegaly. 819 38