Prolactin-secreting Pituitary Carcinoma Research Articles

Pituitary carcinomas: review of the current literature and report of atypical case

Introduction: Pituitary carcinomas are poorly understood, rare entities. They are distinguished from adenomas not by histopathological features but rather by the presence of metastases.Objective: We discuss the diagnosis, mechanism of dissemination and pathogenesis based on a review of the literature and illustrated by a singular case.Case Report: A 59-year-old male presented with a dural-based posterior fossa lesion. He had been diagnosed with a pituitary chromophobe adenoma 43 years earlier that was treated at the time with surgery and radiation therapy. A presumptive diagnosis of a radiation-induced meningioma was made and surgery was recommended. At surgery the tumour resembled a pituitary adenoma. Histopathology, laboratory findings, and the patient’s medical history confirmed the final diagnosis of a prolactin-secreting pituitary carcinoma. To our knowledge, this is the longest reported interval between the pituitary adenoma and metastatic lesion diagnosis (43 years).Conclusion: Management should be tailored to individual patient and may include a combination of treatments (surgery, radiation therapy, chemotherapy, and hormone-targeted therapy). Functionally active tumours may be monitored with hormone levels as tumour markers.

A rare case of prolactin secreting pituitary carcinoma with extra-cranial metastasis

A rare case of prolactin secreting pituitary carcinoma with extra-cranial metastasis

Prolactin Secreting Pituitary Carcinoma with Extracranial Spread Presenting with Pathological Fracture of Femur

Prolactin Secreting Pituitary Carcinoma with Extracranial Spread Presenting with Pathological Fracture of Femur

Good response to temozolamide therapy in a man with a prolactin secreting pituitary carcinoma

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Long-term control of a MEN1 prolactin secreting pituitary carcinoma after temozolomide treatment

We report here a rare case of a young male patient presenting with a Multiple Endocrine Neoplasia Type 1 - prolactin-secreting pituitary carcinoma, controlled long-term after temozolomide withdrawal. Initial presentation was pituitary apoplexy leading to surgery. Dopamine agonists and radiotherapy allowed control of prolactin secretion and pituitary remnant. Metastasis appeared 10 years after initial presentation, leading to the diagnosis of pituitary carcinoma. At that time, dopamine agonists were no more effective; temozolomide, an oral alkylating agent, was administered for 24 cycles, and allowed decrease of the volume of the pituitary lesion and metastases. The patient is still currently followed in our department, 3 years after temozolomide withdrawal: prolactin level and pituitary tumor volume remain controlled without any chemotherapy. To our knowledge, this is the first case of MEN1 prolactin secreting pituitary carcinoma controlled long-term after temozolomide discontinuation.

A case of prolactin-secreting pituitary carcinoma and its histological findings

Pituitary carcinomas are very rare. The diagnosis of pituitary carcinoma is defined by evidence of craniospinal and/or systemic metastasis, rather than by histological malignancies. We report a case of prolactin-secreting pituitary macroadenoma invading the cavernous sinuses at the time of initial treatment, which later metastasized to the cerebellum, medulla oblongata, and spinal axis. The patient survived approximately nine years following the initial diagnosis of a pituitary tumor and two years following the diagnosis of metastatic disease. Histological examination of the metastatic cerebellar tumor showed an adenoma with high cellularity and hyperchromasia, but no mitoses.

Case of the season: Metastatic pituitary carcinoma mimicking meningioma

56-year-old man presented six years ago with a left temporal hemianopsia, gynecomastia, and serum prolactin of 1140 ng/mL. Trans-sphenoidal surgical resection confirmed a prolactin-producing pituitary adenoma and the patient was treated with hormonal therapy and radiotherapy. Five years later, serum prolactin was normal and a magnetic resonance imaging (MRI) study showed no tumor. One year later, he once again complained of breast tenderness and swelling and serum prolactin was 419 ng/mL. MRI showed four separate, enhancing dural-based lesions (Fig. 1). The largest lesion measured 2.3 cm and was located in the left parietal convexity. These extra-axial dural-based lesions were within the previous radiation field. Although the imaging appearance the dural-based lesions had the resemblance of meningioma, the associated rise of serum prolactin suggested the diagnosis of metastatic prolactinoma. The patient underwent a craniotomy with resection of the largest dural-based lesion. Histological examination of the specimen revealed prolactin-secreting adenoma with conspicuous mitotic figures that prompted the diagnosis of prolactin-secreting carcinoma. The patient experienced declining mental status and a continued rise in serum prolactin. He was treated with a prolactin-secretion inhibitor but a new MRI study showed progressive increasing size of the dural lesions. After an episode of aspiration, the patient was admitted to the intensive care unit where ventilator support was withdrawn a few days later. An autopsy limited to the brain showed no residual tumor in the sella turcica. On microscopic examination, all dural lesions were confirmed to be prolactin-secreting pituitary carcinoma.

Prolactin-secreting pituitary carcinoma with implants in the cheek pouch and metastases to the ovaries. A case report and literature review

Prolactin-secreting pituitary carcinomas are uncommon, locally destructive neoplasms that rarely metastasize outside the central nervous system. The authors report a case of a prolactin-secreting tumor that initially presented as the empty sella syndrome. Two recurrences along transsphenoidal surgery tracts in cheek pouches were followed by distant metastases later in the abdomen and pelvis. Only 10 previous cases of either extracranial or intracranial metastases from prolactin-secreting pituitary carcinomas have been reported. No metastases below the diaphragm have been reported previously. The patient's cheek pouch implants, lymph node metastases, ovarian metastases, and uterine metastases were studied with prolactin-specific immunohistochemistry. Long term treatment with bromocriptine, several debulking surgeries, extensive local radiation therapy (external beam and proton beam), and cytotoxic chemotherapy had little impact. Tamoxifen, however, may have slowed tumor growth. Tamoxifen may have efficacy in the treatment of prolactin-secreting pituitary carcinomas.