Dinamika redukcije volumena makroprolaktinoma primjenom dopaminergičkih agonista

master's thesis

• Title (english): Dynamics of macroprolactinom volume reduction by use of dopaminergic agonists
• Author: Kristina Bukvić
• Mentor: Tina Dušek (mentor)
• Committee member: Darko Kaštelan (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Prolaktinomi su najčešći funkcionalni tumori hipofize. Njihovo glavno obilježje je prekomjerna produkcija prolaktina što uzrokuje hiperprolaktinemiju. S obzirom na volumen, obično su podijeljeni u dvije grupe: makroprolaktinomi i mikroprolaktinomi. Makroprolaktinomi su tumori veći od 1 cm, a mikroprolaktinomi su tumori manji od 1 cm. Prolaktinomi se 10 puta češće javljaju kod žena. Prolaktinomi uzrokuju simptome zbog intrakranijalnog rasta što može dovesti do kompresije raznih neuralnih struktura, ali i zbog prekomjernog lučenja prolaktina. Pacijentice najčešće imaju amenoreju i galaktoreju, a muškarci smanjen libido ili erektilnu disfunkciju. Prvu liniju terapije predstavljaju dopaminergički agonisti koji smanjuju tumorski volumen u više od 50% pacijenata. Najčešće se koriste bromokriptin i kabergolin. Kod slabog terapijskog odgovora ili slabe podnošljivosti dopaminergičkih agonista, primjenjuje se druga linija terapije, odnosno transsfenoidalna adenektomija. Ponekad je potrebno liječenje i zračenjem kod pacijenata sa slabim odgovorom na lijekove i kirurško liječenje. Cilj ovog rada bio je promatrati dinamiku smanjenja makroprolaktinoma uz terapiju dopaminergičkim agonistima. Analizirane su povijesti bolesti 19 pacijenata s prolaktinomima većima od 10 mm liječenih isključivo dopaminergičkim agonistima na KBC-u Zagreb. Promatrano je smanjivanje tumora kroz 48 mjeseci terapije i uočeno da je u najvećeg broja pacijenata do smanjenja tumora došlo u prvih godinu dana terapije. Osim toga, uočeno je da je više muškaraca nego žena sa makroprolaktinomima, te da se u muškaraca dijagnoza češće postavi u kasnijoj dobi nego u žena.

Abstract (english)

Prolactinomas are the most common pituitary adenomas. Their main characteristic is excessive production of prolactin which causes hyperprolactinemia. Depending on their volume, they are usually divided into two groups: macroprolactinomas and microprolactinomas. Macroprolactinomas are bigger than 1 cm and microprolatactinomas are smaller than 1 cm. Prolactinomas are 10 times more often among women. Prolactinomas cause symptoms due to intracranial growth of the tumor mass which can compress different neural structures, and also due to excessive prolactin production. Female patients suffer from amenorrhea and galactorrhoea, and male patients have decreased libido or erectile dysfunction. Dopamine agonists are the first-line treatment modality. They reduce tumor volume in more than 50% of patients with prolactinoma. Bromocriptine and cabergoline are dopamine agonists that are most frequently used. The second-line treatment modality is transsphenoidal adenectomy. It is used when there is resistance or intolerance of dopmaine agonists. Sometimes external radiation is necessary in patients with a poor response to medical and surgical procedures. The purpose of the research was to analyze the dynamics of macroprolactinoma volume reduction by use of dopaminergic agonists. Medical history of 19 patients from University Hospital Zagreb with prolactinomas larger than 10 mm and treated only with dopaminergic agonists were analyzed. During the 48-month long observation of tumor volume reduction, it was found that the biggest number of patients exhibited the tumor volume reduction during the first year of therapy. It was also found that there are more male patients with macroprolactinomas than female, and that prolactinomas are usually diagnosed at an older age in men than women.

• Keywords: prolaktinom; hiperprolaktinemija; dopaminergički agonisti; smanjivanje volumena tumora
• Keywords (english): prolactinoma; hyperprolactinemia; dopaminergic agonists; tumor volume reduction
• Language: croatian
• URN:NBN: urn:nbn:hr:105:369705
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-11-24 12:53:09