Endocrine Abstracts

Non-functioning pituitary adenomas (NFPAs) are benign tumors that primarily manifest through pressure effects on surrounding structures. Transsphenoidal surgery serves as the primary intervention, particularly for large, symptomatic tumors, as it provides immediate decompression of adjacent tissues. However, post-operative tumor remnants present an ongoing clinical challenge, with a significant proportion of patients experiencing progressive tumor growth that necessitates additional surgery or radiation therapy. While no medical therapy has received regulatory approval for NFPA treatment, dopamine agonists, particularly cabergoline, have emerged as a promising therapeutic option. Clinical studies demonstrate that cabergoline can prevent remnant tumor growth in 50-60% of patients, with modest tumor shrinkage observed in 20-30% of cases. Preliminary evidence suggests this approach may reduce the frequency of additional therapeutic interventions, though more extensive studies are needed to confirm these findings. The therapeutic response appears independent of dopamine receptor expression levels, suggesting complex underlying mechanisms. Given the typically slow growth pattern of these tumors, developing tools to identify high-risk cases would enhance treatment stratification. The favorable safety profile of low-dose cabergoline, coupled with emerging evidence supporting its efficacy, positions it as a valuable option in the medical management of NFPAs, particularly for post-surgical remnants or when surgery is contraindicated.