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The Effect of Preoperative Cabergoline on Prolactinoma Fibrosis: A Case Series.
Pecorari, Isabella L; Qama, Eros; Akbar, Nadeem; Colley, Patrick; Fang, Christina H; Agarwal, Vijay.
Afiliação
  • Pecorari IL; Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States.
  • Qama E; Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York, United States.
  • Akbar N; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, United States.
  • Colley P; Department of Pathology, Montefiore Medical Center, Bronx, New York, United States.
  • Fang CH; Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, United States.
  • Agarwal V; Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, United States.
J Neurol Surg Rep ; 85(2): e66-e73, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38751869
ABSTRACT
Introduction Prolactinomas are a common intracranial neoplasm and constitute most pituitary tumors. Although patients can present with variable hormone dysregulation and symptom severity, the use of dopamine agonists remains a first-line treatment. While bromocriptine has been found to increase tumor fibrosis, the effect of cabergoline on collagen deposition has been disputed. The aim of this article is to understand the influence of cabergoline on tumor fibrosis prior to resection. Case Presentations Four male patients who underwent prolactinoma resection were included in this report. The average age was 39.8 years (range 26-52 years). Pre-treatment prolactin levels ranged from 957.8 to 16,487.4 ng/mL. Three patients received cabergoline for at least 1 month prior to surgery (treatment range 1-6 months). One patient had surgery without prior cabergoline use. Pathology reports confirmed each tumor to be of lactotroph origin. For each sample, Masson's trichrome staining was performed and the percentage of sample fibrosis was quantified using an artificial intelligence imaging software. Among those who received preoperative cabergoline, the extent of tumor fibrosis was in the range of 50 to 70%. In contrast, specimen fibrosis was approximately 15% without cabergoline use. Conclusion This report demonstrates that a short duration of preoperative cabergoline can cause significant prolactinoma fibrosis. Understanding the effect of cabergoline on tumor consistency prior to surgery is essential as increased fibrosis can lead to more difficult tumor removal, reduce the extent of resection, and increase surgical complications. Considering these effects, further studies regarding the use of surgery prior to cabergoline for prolactinoma management are warranted.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Neurol Surg Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Neurol Surg Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos
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