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A Case of Dopamine Agonists Inhibiting Pancreatic Polypeptide Secretion from an Islet Cell Tumor

Department of Internal Medicine, Section on Endocrinology and Metabolic Diseases, Ochsner Clinic Foundation, New Orleans, Louisiana 70121

Address all correspondence and requests for reprints to: Alan Burshell, M.D., Endocrinology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, Louisiana 70121. E-mail: Aburshell{at}ochsner.org.

A patient with a large prolactinoma developed a metastatic islet cell tumor secreting pancreatic polypeptide. Dopamine agonist drugs reduced the prolactin levels to normal, caused a 7-fold decrease in the pancreatic polypeptide levels, and inhibited the liver metastases. Elevated chromogranin A levels also normalized on the higher doses of bromocriptine. Dopamine receptors are found in many endocrine tissues, and the expression of dopamine-2 receptor on endocrine tumors establishes the potential for response to dopamine agonist treatment. The relatively benign risk profile of dopaminergic agents makes further testing of these drugs to treat neuroendocrine tumors a worthwhile endeavor.

Abbreviations: CgA, Chromogranin A; CT, computed tomography; MEN 1, multiple endocrine neoplasia, type 1; PP, pancreatic polypeptide; PRL, prolactin.