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Malignant prolactinoma.

M Berezin1, I Gutman, R Tadmor

  • 1Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Acta Endocrinologica
|November 1, 1992
PubMed
Summary
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Malignant prolactinoma is rare, with unclear diagnosis and course. This case highlights a 30-year progression, metastasis, and limited treatment response, emphasizing the need for better understanding of this aggressive tumor.

Area of Science:

  • Endocrinology
  • Oncology
  • Neurology

Background:

  • Malignant prolactinoma is an exceptionally rare pituitary tumor with poorly defined diagnostic criteria and clinical progression.
  • Few documented cases exist, making it challenging to establish standard treatment protocols or predict patient outcomes.

Observation:

  • A unique case of malignant prolactinoma is presented in a female patient with a 30-year disease history.
  • The tumor exhibited extensive metastasis to the left eye during the terminal phase, accompanied by extremely elevated prolactin levels (196,000 mU/l).

Findings:

  • High-dose bromocriptine treatment proved ineffective.
  • Pergolide initially showed a positive response for two years, followed by an observed escape effect, indicating treatment resistance.

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  • The patient ultimately succumbed to the disease in a comatose state.

    • Implications:

    • This case underscores the aggressive nature and diagnostic challenges associated with malignant prolactinoma.
    • The limited efficacy of standard treatments like bromocriptine and the transient response to pergolide highlight the need for novel therapeutic strategies.
    • Further research into the pathogenesis and optimal management of malignant prolactinoma is crucial for improving patient survival and quality of life.