Cabergoline should be attempted in progressing non-functioning pituitary macroadenoma

Non-functioning pituitary adenomas (NFPA) usually present with symptoms of mass effect. Thus, the first-line treatment generally consists of transsphenoidal surgery. Since these tumors are usually large and invasive, postsurgical tumor remnants are common. Active surveillance is the follow-up strategy adopted by most pituitary centers, although the prevalence of residual tumor growth may reach 50% in 5-10 years, often leading to repeat surgery, radiation therapy, or both. NFPA remain the only pituitary tumor type for which no medical therapy has been approved. In this debate, we consider the evidence in favor and against using cabergoline to treat progressing NFPA.

Automated summary

Non-functioning pituitary adenomas often require surgery due to their large and invasive nature, leading to common postsurgical tumor remnants. Active surveillance is the typical follow-up strategy, but the high prevalence of residual tumor growth may require repeat surgery or radiation therapy.