How is the disease treated?
Surgical therapy is the primary treatment for
most symptomatic adenomas. There are several surgical approaches to pituitary
masses, but the majority can be removed adequately via the transsphenoidal
approach. This approach offers less morbidity (hypopituitarism, dia-betes
insipidus) and mortality than radiation or transcra-nial resection.
Some of the larger lesions with extensive growth outside the sella are best approached
through a craniotomy. Bromocriptine and L-dopa suppress GH levels and tumor
size after oral administration. Bromocriptine, a dopamine agonist, and L-dopa,
a dopamine precursor, sup-press hypothalamic-mediated GH secretion. These
agents in addition to somatostatin analogs may offer alternatives to surgery in
debilitated or elderly patients. The advantages and disadvantages of various
treatment modalities must be weighed and prescribed according to the individual