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Giant prolactinomas: clinical manifestations and outcomes of 16 Arab cases

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Abstract

Background

The management of giant prolactinomas remains a major challenge, despite dopamine agonists being the first line of treatment, owing to its efficacy to normalize prolactin levels and reduce tumor volume. The aim of this study is to characterize the therapeutic aspects, manifestations and outcomes of 16 cases of giant prolactinomas admitted at a single tertiary center in Riyadh, Saudi Arabia.

Methods

Retrospective data collection involving 16 Saudi patients diagnosed with giant prolactinoma at the Pituitary Clinic in King Fahad Medical City, Riyadh, Saudi Arabia between January 2006 and July 2012.

Results

A total of 16 patients (ten males; six females) with age of diagnosis between 21 and 55 years (mean 34.9 years) were included in the analysis. The most common presenting features include headache, visual defects and sexual dysfunction. Baseline mean serum prolactin level were extremely high for both sexes which eventually decreased by as much as 97 % after cabergoline treatment. Serum prolactin concentrations completely normalized in six patients and significantly decreased in five patients 3–5 times that of normal range. Tumor volume also decreased by an average of 86 % for males and 87 % for females. Two patients had no tumor size change with cabergoline and required surgery.

Conclusion

Findings indicate that cabergoline provides dramatic clinical improvements with excellent safety profile. Cabergoline should therefore be considered as the primary therapy for giant prolactinomas.

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Acknowledgments

This study has been supported by a small grant from the College of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia

    Mussa H. Almalki, Badurudeen Buhary, Saad Alzahrani, Safia Alsherbeni & Naji Aljohani

  2. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Mussa H. Almalki, Saad Alzahrani, Fahad Alshahrani, Ghada Alhowsawi & Naji Aljohani

Authors
  1. Mussa H. Almalki
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  2. Badurudeen Buhary
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  3. Saad Alzahrani
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  4. Fahad Alshahrani
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  5. Safia Alsherbeni
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  6. Ghada Alhowsawi
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  7. Naji Aljohani
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Corresponding author

Correspondence to Mussa H. Almalki.

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Almalki, M.H., Buhary, B., Alzahrani, S. et al. Giant prolactinomas: clinical manifestations and outcomes of 16 Arab cases. Pituitary 18, 405–409 (2015). https://doi.org/10.1007/s11102-014-0588-3

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  • DOI: https://doi.org/10.1007/s11102-014-0588-3

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