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Related Experiment Video

Updated: Sep 25, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Published on: January 17, 2018

Aggressive giant prolactinoma: a case report.

Marisa Khatijah Borhan¹, Florence Hui Sieng Tan²

¹Endocrinology Unit, Medical Department, Sarawak General Hospital, Kuching Sarawak, Malaysia. mkborhan@gmail.com.

Journal of Medical Case Reports

|April 30, 2022

Summary

Treatment-resistant aggressive giant prolactinoma requires early identification and a multidisciplinary approach. Temozolomide therapy offers a viable option for young patients with aggressive prolactinoma when other treatments fail.

Keywords:

Aggressive prolactinoma Case report Giant prolactinoma Temozolomide

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Area of Science:

Endocrinology
Oncology
Neurosurgery

Background:

Aggressive giant prolactinoma management is challenging due to limited treatment options beyond dopamine agonists, surgery, and radiotherapy.
Treatment resistance and tumor progression necessitate alternative therapeutic strategies.

Observation:

A 21-year-old woman presented with a 2.8 × 3.2 × 4.2 cm³ giant prolactinoma causing vision loss and amenorrhea.
Initial treatment with cabergoline achieved partial response, but the tumor recurred aggressively despite multiple surgeries and escalated medication.
The patient developed treatment-resistant aggressive prolactinoma with suprasellar extension and optic chiasmal compression.

Findings:

Despite maximal medical and surgical interventions, the patient's aggressive prolactinoma continued to progress.
Temozolomide therapy was initiated after multidisciplinary consultation, considering the long-term risks of radiotherapy in a young patient.

Implications:

Early identification of treatment-resistant aggressive prolactinoma is crucial for timely intervention.
A multidisciplinary approach is essential for managing aggressive prolactinoma in young individuals.
Temozolomide therapy represents a potential treatment option for aggressive, treatment-resistant prolactinoma, particularly when radiotherapy is contraindicated.