Abstract
Official Journal of the Endocrine Society of Sri Lanka. The Sri Lanka Journal of Diabetes Endocrinology and Metabolism (SJDEM) publishes original research articles, reviews, and other special features related to diabetes, endocrinology and metabolism in humans and human tissue.
Highlights
Prolactinomas are amenable to medical treatment alone using dopamine agonists, with high probability of disease control with endocrine and radiographic remission
(3) Pharmacology of temozolomide identifies that it rapidly converts into active 5-(3-methyl-triazeno)-imidazole-4-carboxamide responsible for DNA lesions by binding methyl groups at O6-guanine leading to DNA mismatch and cell apoptosis (6)
Despite limited clinical data on the long-term side effects of temozolomide, in selected cases, consideration should be given to using temozolomide earlier in the treatment algorithm to prevent repeated surgical interventions or radiotherapy related adverse effects to achieve endocrine and radiological remission of prolactinomas
Summary
Prolactinomas are amenable to medical treatment alone using dopamine agonists, with high probability of disease control with endocrine and radiographic remission. The importance of compliance was reinforced A 23-year-old gentleman of Chinese descent presented at the age of 14 years with features of bitemporal hemianopia at a private health institution He underwent MRI imaging which confirmed the diagnosis of a pituitary macroadenoma and the initial prolactin levels were documented as 8800mU/L. He underwent transsphenoidal surgical resection of the tumour at age 14 and a repeat surgery at 16 years of age. He developed despite good compliance and up titration of cabergoline doses (total dose of 12mg/week), prolactin levels continued to increase exponentially. Contrast-enhanced coronal T-1 weighted MRI showing significant remission in lesion 52 weeks after neo-adjuvant therapy with temozolamide
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