[Malignant prolactinoma with intra- and extracranial metastasis: clinico-radiologic study]

Malignant prolactinomas are very rare pituitary neoplasms which can be identified not from the hystopathologic nor neuroimaging aspects but only retrospectively from the presence of distant metastases. A 32-year-old male patient was diagnosed of a pituitary prolactinoma because of bitemporal hemianopsia on the basis of cranial MRI aspect and raised blood prolactin level. Visual signs improved under bromocriptine treatment but after surgical and X-ray therapies patient developed paralysis of V and XII left cranial nerves and suffered from medulocerebelous angle, vertebrae, spinal epidural space, lung, liver, suprarenal and femoral metastases. Patient died 3 years after the diagnosis time. Prolactin levels raised 2000 ng/ml. This is the first case of malignant prolactinoma described in the spanish literature and the more large one in number of metastatic localizations between the malignant prolactinomas from the literature. These kind of neoplasms can be partially ameliorated under X-ray and bromocriptine treatment but there is not, by the moment, a curative chemotherapy.