Does Bromocriptine Have a Cytocidal Effect on Prolactinoma Cells?

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Abstract
A 16-year-old girl with prolactin secreting pituitary adenoma was treated with 2.5 to 30 mg/day of bromocriptine for about eight months, followed by transsphenoidal surgery. The preadministration baseline value of prolactin (PRL) was 13, 886 ng/ml, which markedly decreased to 6.6 ng/ml after bromocriptine treatment. Computed tomography (CT) performed before bromocriptine administration showed the presence of a large, irregularly shaped suprasellar extension of the tumor. About eight months after bromocriptine treatment, reduction of tumor size was revealed by CT scans, but a small enhanced mass was still present in the sella turtica and suprasellar areas. Postoperatively, administration of bromocriptine was suspended for about two weeks and the blood PRL value increased rapidly to 2, 960 ng/ml. Histology of the tumor tissue consisted mainly of two components, i.e., island-like, shrunken tumor cell nests and acellular spaces which surrounded these tumor cell nests. The acellular spaces were considered to be the spaces left after the majority of the prolactinoma cells had died and disappeared. Thus, the marked tumor size reduction and marked decrease of blood PRL level in this case can be explained by the “cytocidal” and “cytostatic” effects of bromocriptine on prolactinoma cells.

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