Giant prolactinoma: case report and review of literature

Abstract

“Invasive giant prolactinoma” is a large prolactinoma (>4 cm in dimension) presenting with serum prolactin levels of >1000 ng/dL and mass related clinical symptoms. Here we report a patient with a giant prolactinoma presented with central hypogonadism, suppressed adrenal and thyroid function, supra sellar extension, visual field impairment and high prolactin level.The patient was treated with cabergoline, levothyroxin and prednisolone. After 18 months, tumor size markedly reduced, associated with adrenal function and visual field improvement, but central hypogonadism and secondary hypothyroidism persisted.Previous studies showed normalization of thyrotropin secretion after treatment but it remained low in our patient even after 18 months follow up.

Update on prolactinomas. Part 2: Treatment and management strategies

“…1) [2,15]. For most microprolactinomas, dopamine agonists restore gonadal function in 80-90% of patients [16,17].…”

“…The dosage typically starts at 0.25-0.5 mg/week and is increased weekly until normal prolactin levels are achieved [12]. Cabergoline is the primary pharmacological treatment for aggressive macroprolactinomas [15,16,24]. It is also efficacious in managing hyperprolactinemia and tumor shrinkage in patients who are either resistant or intolerant to bromocriptine [25].…”

Breast carcinoma associated with prolactinoma: A case report

“…4,5 Prolactinoma is a common type of pituitary adenoma that leads to excessive secretion of PRL and causes infertility, menstrual irregularity and galactorrhea in women. 6 Herein, we report the case of a patient who was diagnosed with prolactinoma associated with breast cancer. To our knowledge, only a few cases exist in which both pituitary and breast tumors are found together at the time of presentation.…”

Ten-year follow-up of a giant prolactinoma

“…There are several reports of a pronounced and fast response of these tumours to this medical therapy 4 7 11. Nevertheless, the majority of patients with giant prolactinomas need lifelong medical therapy and cure is very rare 1…”