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Chordoma presenting as pseudoprolactinoma.
A Haridas1, S Ansari, F Afshar
1Department of Neurological Surgery, Royal London Hospital, Whitechapel, London, UK.
British Journal of Neurosurgery
|October 21, 2003
Summary
Chordomas, rare tumors from notochord remnants, can rarely mimic prolactinomas by causing high prolactin levels. This case highlights a chordoma presenting as a pseudoprolactinoma.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Chordomas are rare, typically slow-growing bone tumors originating from notochordal remnants.
- They most commonly occur in the sacrum and spine, but cranial chordomas, particularly those involving the clivus, are rare.
- Intracranial chordomas account for approximately 0.15% of all brain neoplasms.
Observation:
- This report details a rare case of an intracranial chordoma presenting with significantly elevated prolactin levels.
- The patient's presentation mimicked that of a prolactinoma, a pituitary tumor causing excess prolactin secretion.
- This unusual presentation highlights the diverse and sometimes misleading clinical manifestations of chordomas.
Findings:
- Radiological imaging revealed a clival chordoma, distinct from a pituitary or sellar mass.
- Endocrine evaluation showed hyperprolactinemia, consistent with pseudoprolactinoma.
- Histopathological examination confirmed the diagnosis of chordoma.
Implications:
- This case underscores the importance of considering chordomas in the differential diagnosis of hyperprolactinemia, especially with atypical radiological findings.
- Accurate diagnosis requires a multidisciplinary approach involving neurosurgery, endocrinology, and radiology.
- Understanding rare presentations like pseudoprolactinoma is crucial for timely and appropriate patient management.