Breast carcinoma associated with prolactinoma: A case report

Zheng, Yurong; Mo, Wenju; Ye, Yu; Zou, Dayang; He, Xiangming; Xia, Xianghou; Hu, Jian

doi:10.1080/15384047.2017.1294284

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…There are experimental data indicating that prolactin might play a role in progression and invasion of several cancer types, especially breast cancer ( Clevenger et al 2003 , Liby et al 2003 ) . Several case reports of breast cancer in both females and males with prolactinoma confirm experimental data ( Forloni et al 2001 , Sato et al 2007 , Mallawaarachchi et al 2011 , Zheng et al 2017 , Bettencourt-Silva et al 2018 , Hao et al 2020 ). Both diagnoses were either diagnosed simultaneously or in the majority, with a significant latency period up to 32–36 years questioning the role of hyperprolactinemia in inducing cancer.…”

Section: The Risk Of Malignancy In Patients With Sporadic Pituitary A...supporting

confidence: 66%

Pituitary tumors and the risk of other malignancies: is the relationship coincidental or causal?

2022

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Pituitary adenomas are benign neoplasms of the pituitary. The most prevalent are prolactinomas and nonfunctioning pituitary adenomas, followed by growth hormone- and ACTH-secreting adenomas. Most pituitary adenomas seem to be sporadic and their persistent growth is very atypical. No molecular markers predict their behavior. The occurrence of pituitary adenomas and malignancies in the same patient can be either pure coincidence or caused by shared underlying genetic susceptibility involved in tumorigenesis. Detailed family history on cancers/tumors in the first, second and third generation of family members on each side of the family has been reported in a few studies. They found an association of pituitary tumors with positive family history for breast, lung and colorectal cancer. We have reported that in about 50% of patients with pituitary adenomas an association with positive family history for cancer has been found independent of secretory phenotype (acromegaly, prolactinoma, Cushingʼs disease or non-functioning pituitary adenomas). We also found earlier onset of pituitary tumors (younger age at diagnosis of pituitary tumors) in patients with strong family history of cancer. In our recent unpublished series of 1300 patients with pituitary adenomas, 6.8% of patients were diagnosed with malignancy. The latency period between the diagnosis of pituitary adenoma and cancer was variable and in 33% of patients was longer than 5 years. Besides the inherited trophic mechanisms (shared underlying genetic variants), the potential influence of shared complex epigenetic influences (environmental and behavioral factors -obesity, smoking, alcohol intake, insulin resistance) is discussed. Further studies are needed to better understand if patients with pituitary adenomas are at increased risk for cancer.

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Section: The Risk Of Malignancy In Patients With Sporadic Pituitary A...supporting

confidence: 66%

Pituitary tumors and the risk of other malignancies: is the relationship coincidental or causal?

2022

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“…PRL receptors are highly over-expressed in malignant breast cancer tissue when compared with normal breast tissue. Several case reports of breast carcinomas in patients with prolactinomas have been reported [ 8 – 10 ]. Two case-control studies of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were carried out regarding this issue.…”

Section: Discussionmentioning

confidence: 99%

Giant prolactinoma, germline BRCA1 mutation, and depression: a case report

et al. 2018

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BackgroundGiant prolactinomas are very rare pituitary tumors that may exhibit an aggressive behavior and present with a life-threatening condition.Case presentationA 25-year-old white woman was admitted to our hospital with a headache, psychomotor retardation, reduced vision, and loss of autonomy in daily activities. Her past medical history was significant for having oligomenorrhea and a depressive syndrome since her mother’s death. She also had a breast cancer gene 1 (BRCA1) mutation and a family history of breast cancer. She had marked hyperprolactinemia (7615 ng/dL), central hypocortisolism, growth hormone deficiency, and a giant pituitary tumor (52 × 30 × 33 mm) which was shown in magnetic resonance imaging with obstructive hydrocephalus, requiring emergency surgery. Treatment with cabergoline led to a 99.8% reduction in serum prolactin levels and significant tumor shrinkage. Her depressive symptoms progressively improved and psychiatric drugs were withdrawn after 3 months of cabergoline treatment. Currently, she is being followed in Endocrinology, Neurosurgery, and Neurophthalmology out-patient clinics and in a breast cancer unit. Careful monitoring, support, and follow-up will be essential throughout this patient’s life.ConclusionsThis case is a rare presentation of a giant prolactinoma in a young woman, who presented a life-threatening event. She also had an unexpected association between diseases or symptoms that may have contributed to the delay in diagnosis. Given the concomitant presence of a giant prolactinoma, a BRCA1 mutation, and depressive symptoms, a possible association was hypothesized. The breast cancer risk in a BRCA1 mutation carrier and the possible interference of hyperprolactinemia and life events were also discussed. However this hypothesis requires further investigation.

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