Resumen

MANGUPLI, Ruth. Tratamiento de los prolactinomas y tumores secretores de hormona de crecimiento. Rev. Venez. Endocrinol. Metab. [online]. 2005, vol.3, n.1, pp.10-16. ISSN 1690-3110.

Pituitary adenomas represent 10% of all the diagnosed intracraneal tumors, and 25% of the surgically treated brain tumors. The goals of treatment in a patient with a pituitary adenoma include elimination of the mass effect, lowering excessive hormone production, restoration of normal pituitary function, and prevention of recurrence. The primary therapy for all prolactinomas is a dopamine agonist. Bromocriptine and cabergoline are both effective in reducing the size of the tumor and restoring gonadal funtion. Surgery should be recommended only when medical therapy have failed. Growth hormone secreting pituitary tumors are usually treated first with surgical resection by a transphenoidal adenomectomy, but strict normalization of HC and IGF-1 values occur in less than half of patients with a macroadenoma, therefore a substantial number of acromegalic patients require aditional therapy. Somatostatin analogs are at present the most widely used drugs for control of acromegaly with excellent results. In selected patients combined treatment with dopamine agonist and somatostatin seems to suppress HC levels better than either drug given separately. Pegvisomant is a HC receptor antagonist that promises a very high HC rate of normalization of IGF-1 in patients with acromegaly.

Palabras clave : Prolactinoma; growth hormone tumors; treatment.