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Controversies in the treatment of endocrine tumors: medical and surgical management of prolactinomas, acromegaly and thyroid cancer

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Diagnosis and Management of Endocrine-related Tumors

Part of the book series: Cancer Treatment and Research ((CTAR,volume 20))

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Abstract

Controversy arises in medicine with regard to therapy whenever multiple effective treatments have not been rigorously compared in a controlled fashion. For this reason, various investigators advocate surgery [1, 2], radiation [3, 4], or medical therapy [5, 6] (at least for prolactinomas), as the initial treatment of choice of functioning pituitary tumors. Controlled, prospective clinical trials comparing the relative efficacy and safety of these treatments do not currently exist to guide the choice of therapy for pituitary tumors. Consequently, therapeutic decisions remain subjective and frequently reflect the background training of the physician.

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References

  1. Post KD, Biller BJ, Adelman LS, Molitch ME, Wolpert SM, Reichlin S: Selective transsphenoidal adenomectomy in women with galactorrhea-amenorrhea. J Am Med Assoc 242: 158–162, 1979.

    Article  CAS  Google Scholar 

  2. Tucker HS-G, Grubb SR, Wigand JP, Watlington CO, Blackard WG, Becker DP: The treatment of acromegaly by transsphenoidal surgery. Arch Intern Med 140: 795–802, 1980.

    Article  PubMed  CAS  Google Scholar 

  3. Eastman RC, Gorden P, Roth J: Conventional supervoltage irradiation is an effective treatment for acromegaly. J Clin Endocrinol Metab 48: 931–940, 1979.

    Article  PubMed  CAS  Google Scholar 

  4. Grossman A, Cohen BL, Plowman N, Wass JAH, Jones A, Besser GM: Long-term effects of radiotherapy in patients with prolactin secreting pituitary adenomas. Program of the 65th Annual Meeting of the Endocrine Society, San Antonio, Texas, June, 1983 (Abstr 436), p 189.

    Google Scholar 

  5. Thorner MD, Besser GM: Bromocriptine treatment of hyperprolactinaemic hypogonadism. Acta Endocrinol (Suppl) (Copenh) 216: 131–146, 1978.

    CAS  Google Scholar 

  6. del Pozo E, Varga L, Wyss H, Tolis G, Friesen H, Wenner R, Vetter L, Uettwiler A: Clinical and hormonal response to bromocriptin (CB-154) in the galactorrhea syndromes. J Clin Endocrinol Metab 39: 18–26, 1974.

    Article  PubMed  Google Scholar 

  7. Kleinberg DL, Frantz AG: Human prolactin: measurement in plasma by in vitro bioassay. J Clin Invest 50: 1557–1568, 1971.

    Article  PubMed  CAS  Google Scholar 

  8. Arafah BM, Brodkey JS, Pearson OH: Prolactin secreting pituitary adenomas in women. In: Endocrine-Related Tumors I, Santen RJ, Manni A (eds), The Hague: Martinus-Nijhoff Publishers, 1984, pp 63–79.

    Google Scholar 

  9. Tolis G, Franks S: Physiology and pathology of prolactin secretion. In: Clinical Neuroendocrinology: A Pathophysiological Approach, Tolis G, Labrie F, Martin JB, Naftolin F (eds). New York: Raven Press, 1979, pp 291–317.

    Google Scholar 

  10. Post KD, Biller BJ, Adelman LS, Molitch ME, Wolpert SM, Reichlin S: Selective transsphenoidal adenomectomy in women with galactorrheaamenorrhea. J Am Med Assoc 242: 158–162, 1979.

    Article  CAS  Google Scholar 

  11. Franks S, Murray MAF, Jequier AM, Steele SJ, Nabarro JDN, Jacobs HS: Incidence and significance of hyperprolactinaemia in women with amenorrhoea. Clin Endocrinol 4: 597–607, 1975.

    Article  CAS  Google Scholar 

  12. Kleinberg DL, Noel GL, Frantz AG: Gaactorrhea: a study of 235 cases, including 48 with pituitary tumors. N Engl J Med 296: 589–600, 1977.

    Article  PubMed  CAS  Google Scholar 

  13. Hancock KW, Scott JS, Lamb JT, Gibson RM, Chapman C: Conservative management of pituitary prolactinomas: evidence for bromocriptine induced regression. Br J Obstet Gynecol 87: 523–529, 1980.

    Article  CAS  Google Scholar 

  14. March CM, Kletzky OA, Davajan V, Teal J, Weiss M, Apuzzo ML, Marrs RP, Mishell DR Jr. Longitudinal evaluation of patients with untreated prolactin-secreting pituitary adenomas. Am J Obstet Gynecol 139: 835–844, 1981.

    PubMed  CAS  Google Scholar 

  15. Burrow GN, Wortzman G, Rewcastle NB, Holgate RC, Kovacs K: Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med 304: 156–158, 1981.

    Article  PubMed  CAS  Google Scholar 

  16. Randall S, Laing I, Chapman AJ, Shalet SM, Beardwell CG, Kelly WF, Davies D: Pregnancies in women with hyperprolactinaemia: obstetric and endocrinological management of 50 pregnancies in 37 women. Br J Obstet Gynecol 89: 20–23, 1982.

    CAS  Google Scholar 

  17. Klibanski A, Neer RM, Beitins IZ, Zervas NT, McArthur JW: Decreased bone density in hyperprolactinemic women. Med Intelligence 303: 1511–1514, 1980.

    CAS  Google Scholar 

  18. Schlechte JA, Sherman B, Martin R: Bone density in amenorrheic women with and without hyperprolactinemia. J Clin Endocrinol Metab 56: 1120–1123, 1983.

    Article  PubMed  CAS  Google Scholar 

  19. Robinson AG, Nelson PB: Prolactinomas in women: current therapies. Ann Int Med 99: 115–118, 1983.

    PubMed  CAS  Google Scholar 

  20. Serri O, Rasio E, Beauregard H, Hardy J, Somma M: Recurrence of hyperprolactinemia after selective transsphenoidal adenomectomy in women with prolactinoma. N Engl J Med 309: 280–283, 1983.

    Article  PubMed  CAS  Google Scholar 

  21. Turkalj I, Braun P, Krupp P: Surveillance of bromocriptine in pregnancy. J Am Med Assoc 247: 1589–1591, 1982.

    Article  CAS  Google Scholar 

  22. Gemzell C, Wang CF: Outcome of pregnancy in women with pituitary adenoma. Fertil Steril 31: 363–372, 1979.

    PubMed  CAS  Google Scholar 

  23. Thorner MO, Edwards CRW, Charlesworth M, Dacie JE, Moult PJ, Rees LH, Jones AE, Besser GM: Pregnancy in patients presenting with hyperprolactinaemia. Br Med J 11: 771–774, 1979.

    Article  Google Scholar 

  24. Dommerholt HBR, Assies J, Van Der Werf AFM: Growth of a prolactinoma during pregnancy: case report and review. Br J Obstet Gynecol 88: 62–70, 1981.

    Article  CAS  Google Scholar 

  25. Bergh T, Nillius SJ, Wide L: Clinical course and outcome of pregnancies in amenorrhoeic women with hyperprolactinaemia and pituitary tumors. Br Med J 1: 875–880, 1978.

    Article  PubMed  CAS  Google Scholar 

  26. Thorner MO, Martin WH, Rogol AD, Morris JL, Perryman RL, Conway BP, Howards SS, Wolfman MG, MacLeod RM: Rapid regression of pituitary prolactinomas during bromocriptine treatment. J Clin Endocrinol Metab 51: 438–445, 1980.

    Article  PubMed  CAS  Google Scholar 

  27. Corenblum B, Hanley DA: Bromocriptine reduction of prolactinoma size. Fertil Steril 36: 716–719, 1981.

    PubMed  CAS  Google Scholar 

  28. Thorner MO, Perryman RL, Rogol AD, Conway BP, MacLeod RM, Login IS, Morris JL: Rapid changes of prolactinoma volume after withdrawal and reinstitution of bromocriptine. J Clin Endocrinol Metab 153: 480–483, 1981.

    Article  Google Scholar 

  29. Landolt AM, Keller PJ, Froesch ER, Mueller J: Bromocriptine: Does it jeopardize the result of later surgery for prolactinomas. Lancet ii: 657–658, 1982.

    Article  Google Scholar 

  30. Faglia G, Moriondo P, Travaglini P, Giovanelli MA: Influence of previous bromocriptine therapy on surgery for microprolactinoma. Lancet i: 133–134, 1983.

    Article  Google Scholar 

  31. Sheline GE: Role of conventional radiation therapy in the treatment of functional pituitary tumors. In: Recent Advances in the Diagnosis and Treatment of Pituitary Tumors, Linfoot JA (ed). New York: Raven Press, 1979, p 442.

    Google Scholar 

  32. Thorner MO, Perryman RL, Cronin MJ, Rogol AD, Draznin M, Johanson A, Vale W, Horvath E, Kovacs K: Somatrotroph hyperplasia: successful treatment of acromegaly by removal of a pancreatic islet tumor secreting a growth hormone-releasing factor. J Clin Invest 70: 965–977, 1982.

    Article  PubMed  CAS  Google Scholar 

  33. Guillemin R, Brazeau P, Bohlen P, Esch F, Ling N, Wehrenberg WB: Growth hormonereleasing factor from a human pancreatic tumor that caused acromegaly. Science 218: 585–587, 1982.

    Article  PubMed  CAS  Google Scholar 

  34. Evans HM, Briggs JH, Dixon JS: The physiology and chemistry of growth hormone. Acromegaly. In: The Pituitary Gland, Harris GW, Donovan BT (eds). Berkely and Los Angeles: University of California Press, 1966, p 439.

    Google Scholar 

  35. Wright AD, Hill DM, Lowry C, Fraser TR: Mortality in acromegaly. Q J Med 39: 1–16, 1970.

    PubMed  CAS  Google Scholar 

  36. Arafah BM, Brodkey JS, Pearson OH: Acromegaly. In: Endocrine-Related Tumors 1, Santen RJ, A Manni (eds). The Hague: Martinus-Nijhoff Publishers, 1984, pp 45–61.

    Google Scholar 

  37. Atkinson RL, Becker DP, Martins AN, Schaaf M, Dimond RC, Wartofsky L, Earll JM: Acromegaly. Treatment by transsphenoidal microsurgery. J A Med Assoc 233: 1279–1283, 1975.

    Article  CAS  Google Scholar 

  38. Kjellberg RN, Kliman B: A system for therapy of pituitary tumors: Proton or surgical therapy. In: Diagnosis and Treatment of Pituitary Tumors, Kohler PO, Ross GT (eds). Amsterdam: Excerpta Medica, 1973, pp 234–252.

    Google Scholar 

  39. Lawrence JH, Chong CY, Lyman JT: Treatment of pituitary tumors with heavy particles. In: Diagnosis and Treatment of Pituitary Tumors, Kohler PO, Ross GT (eds). Amsterdam: Excerpta Medica, 1973, pp 253–262.

    Google Scholar 

  40. Boyd AE, Lebovitz HE, Pfeiffer JB: Stimulation of human growth hormone secretion by L-dopa. N Engl J Med 238: 1425–1429, 1970.

    Article  Google Scholar 

  41. Belforte L, Camanni F, Chiodini PG, Liuzzi A, Massara F, Molinatti GM, Muller EE, Silvestrini F: Long-term treatment with 2-Br-a-ergocryptine in acromegaly. Acta Endocrinol 85: 235–248, 1977.

    PubMed  CAS  Google Scholar 

  42. Sachdev Y, Gomez-Pan A, Turnbridge WMG, Duns A, Weightman DR, Hall R, Goolamali SK: Bromocriptine therapy in acromegaly. Lancet 2: 1164–1167, 1975.

    Article  PubMed  CAS  Google Scholar 

  43. Moses AC, Molitch ME, Sawin CT, Jackson IMD, Biller BJ, Furlanetto R, Reichlin S: Bromocriptine therapy in acromegaly: Use in patients resistant to conventional therapy and effect on serum levels of somatomedin C. J Clin Endocrinol Metab 53: 752–758, 1981.

    Article  PubMed  CAS  Google Scholar 

  44. Schwinn G, Dirks H, Mcintosh C, Kobberling J: Metabolic and clinical studies on patients with acromegaly treated with bromocriptine over 22 months. Eur J Clin Invest 7: 101–107, 1977.

    Article  PubMed  CAS  Google Scholar 

  45. Wass JAH, Moult PJ, Thorner MO, Dacie JE, Charlesworth M, Jones AE, Besser GM: Reduction of pituitary tumor size in patients with prolactinomas and acromegaly treated with bromocriptine with and without radiotherapy. Lancet 2: 66–69, 1979.

    Article  PubMed  CAS  Google Scholar 

  46. Chiodini PG, Liuzzi A, Cozzi R: Macroprolactinomas and GH secreting adenomas: medical treatment. In: Program of the International Symposium on Pituitary Hormones and Related Peptides, Motta M (ed). San Marino, 1981, 55 (abstr).

    Google Scholar 

  47. Wollesen F, Andersen T, Karle A: Size reduction of extrasellar pituitary tumors during bromocriptine treatment. Ann Intern Med 96: 281–286, 1982.

    PubMed  CAS  Google Scholar 

  48. Leeper R: Controversies in the treatment thyroid cancer: The New York Memorial Hospital approach. In: Thyroid Today, Vol 4, July/Aug, 1982.

    Google Scholar 

  49. Cady B, Sedgwick CE, Meissner WA, Wool MS, Salzman FA, Werber J: Risk factor analysis in differentiated thyroid cancer. Cancer 43: 810–820, 1979.

    Article  PubMed  CAS  Google Scholar 

  50. Woolner LB: Thyroid carcinoma: pathologic classification with data on prognosis. Semin Nucl Med 1: 481–502, 1971.

    Article  PubMed  CAS  Google Scholar 

  51. Wanebo HJ, Andrews W, Kaiser DL: Thyroid cancer: some basic considerations. Ca 33: 87–97, 1983.

    PubMed  CAS  Google Scholar 

  52. Tollefsen HR, Shah JP, Huvos AG: Papillary carcinoma of the thyroid. Am J Surg 124: 468–472, 1972.

    Article  PubMed  CAS  Google Scholar 

  53. Buckwalter JA, Thomas CG Jr: Selection of surgical treatment for well differentiated thyroid carcinomas. Ann Surg 176: 565–578, 1972.

    PubMed  CAS  Google Scholar 

  54. Crile G Jr: Changing end results in patients with papillary carcinoma of the thyroid. Surg. Gynec Obstet 71: 460–468, 1971.

    Google Scholar 

  55. Mazzaferri EL, Young RL, Oertel JE, Kemmerer WT, Page CP: Papillary thyroid carcinoma: the impact of therapy in 576 patients. Medicine 56: 171–196, 1977.

    Article  PubMed  CAS  Google Scholar 

  56. Young RL, Mazzaferri EL, Rahe AJ, Dorfman SG: Pure follicular thyroid carcinoma: Impact of therapy in 214 patients. J Nucl Med 21: 733–737, 1980.

    PubMed  CAS  Google Scholar 

  57. Samaan NA, Maheshwari YK, Nader S, Hill CS Jr, Schultz PN, Haynie TP, Hickey RC, Clark RL, Goepfert H, Ibanez ML, Litton CE: Impact of therapy for differentiated carcinoma of the thyroid: an analysis of 706 cases. J Clin Endocrinol Metab 56: 1131–1138, 1983.

    Article  PubMed  CAS  Google Scholar 

  58. Schneider AB, Line BR, Goldman JM, Robbins J: Sequential serum thyroglobulin determinations, 131I scans, and131 uptakes after triiodothyronine withdrawal in patients with thyroid cancer. J Clin Endocrinol Metab 53: 1199–1206, 1981.

    Article  PubMed  CAS  Google Scholar 

  59. Beierwaltes WH: The treatment of thyroid carcinoma with radioactive iodine. Semin Nucl Med VIII: 79–94, 1978.

    Article  Google Scholar 

  60. Cady B, Sedgwick CE, Meissner WA, Bookwalter JR, Romagosa V, Werber J: Changing clinical, pathologic, therapeutic, and survival patterns in differentiated thyroid carcinoma. Ann Surg 184: 541–553, 1976.

    Article  PubMed  CAS  Google Scholar 

  61. Mazzaferri EL, Young RL: Papillary thyroid carcinoma: A 10 year follow-up report of the impact of therapy in 576 patients. Am J Med 70: 511–518, 1981.

    Article  PubMed  CAS  Google Scholar 

  62. Harwood J, Clark OH, Dunphy JE: Significance of lymph node metastasis in differentiated thyroid cancer. Am J Surg 136: 107–112, 1978.

    Article  PubMed  CAS  Google Scholar 

  63. DeGroot LJ: Natural history and therapy of thyroid cancers. In: 35th Postgraduate Assembly of The Endocrine Society, Boston, MA, Oct 24–28, 1983, p 252–270.

    Google Scholar 

  64. Jacobs JK, Aland JW Jr, Ballinger JF: Total thyroidectomy. A review of 213 patients. Ann Surg 197: 542–549, 1983.

    Article  PubMed  CAS  Google Scholar 

  65. Pochin EE: Prospects from the treatment of thyroid carcinoma with radioiodine. Clin Radiol 18: 113–135, 1967.

    Article  PubMed  CAS  Google Scholar 

  66. Winship T, Rasvall RV: Thyroid carcinoma in childhood: Final report on a 20 year old study. Clin Proc Child Hosp 26: 327, 1970.

    Google Scholar 

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© 1984 Martinus Nijhoff Publishers, Boston

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Santen, R.J., Manni, A. (1984). Controversies in the treatment of endocrine tumors: medical and surgical management of prolactinomas, acromegaly and thyroid cancer. In: Santen, R.J., Manni, A. (eds) Diagnosis and Management of Endocrine-related Tumors. Cancer Treatment and Research, vol 20. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2849-0_16

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  • DOI: https://doi.org/10.1007/978-1-4613-2849-0_16

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