Amyloidogenic Pituitary Prolactinoma

Abstract

Prolactinomas are the most common benign pituitary neoplasms and the common cause of hyperprolactinemia. Most of them arise in women of reproductive age. In men, they are often functionally silent, but present with manifestations secondary to pressure effects when they become macro adenomas. We present a case of prolactinoma in a 54-year old male patient who presented with pressure effects because of the tumor, as head ache and bi-temporal hemianopsia. MRI Brain scan was done to identify the tumor. The patient underwent trans-sphenoidal resection of the pituitary macro adenoma. Histological examination revealed spheroid amyloid deposits, almost replacing the adenoma. No medical treatment was given but the tumor recurred after 6 months and a repeat surgery was done for total excision.

Pituitary prolactinoma with amyloid deposits: Surgery or dopamine agonists? Review of previous reports and new recommendations for management

“…Our diagnosis was made after the histological report arrived. Premalatha et al [15] report a similar case in 2016, where surgery was performed directly as amyloid was not diagnosed on preoperative imaging.…”