Hedner P, Valdemarsson S
Department of Medicine, University Hospital, Lund, Sweden.
Neurosurgery. 1989 Dec;25(6):948-50. doi: 10.1097/00006123-198912000-00015.
A 39-year-old woman with secondary amenorrhea and visual field defects underwent craniotomy for a large pituitary tumor that was hormonally silent according to measurement of plasma hormone levels and immunohistochemical analysis. During the preoperative investigation, bromocriptine was administered for 1 month, but there was no change in the tumor size as seen on computed tomographic scans. One month after surgery, visual field defects recurred, and a tumor mass comparable to the preoperative state was found on computed tomographic scan. The tumor size gradually diminished during treatment with CV 205-502, a tricyclic benzoquinoline which stimulates mainly D2 receptors and is better tolerated than bromocriptine. The visual fields were completely normalized after 3 months of treatment with the drug, and surgical management of the tumor mass was no longer considered to be necessary. Thus, as in many similar cases, the hormonally silent pituitary tumor in this patient proved unresponsive to bromocriptine treatment. In contrast, the tumor was reduced by therapy with CV 205-502, a drug that is better tolerated and might permit a more intense stimulation of D2 receptors.
一名39岁继发性闭经且有视野缺损的女性因巨大垂体瘤接受了开颅手术，根据血浆激素水平测定和免疫组化分析，该肿瘤在激素方面无活性。术前检查期间，给予溴隐亭治疗1个月，但计算机断层扫描显示肿瘤大小无变化。术后1个月，视野缺损复发，计算机断层扫描发现了一个与术前状态相当的肿瘤块。在用CV 205 - 502治疗期间，肿瘤大小逐渐缩小，CV 205 - 502是一种三环苯并喹啉，主要刺激D2受体，耐受性比溴隐亭更好。用药3个月后视野完全恢复正常，不再认为有必要对肿瘤块进行手术处理。因此，与许多类似病例一样，该患者的激素无活性垂体瘤对溴隐亭治疗无反应。相比之下，用CV 205 - 502治疗使肿瘤缩小，该药物耐受性更好，可能允许更强烈地刺激D2受体。
