It Keeps Getting Bigger: A Patient With a Hypothalamic Tumor and Hyperprolactinemia

Internists might occasionally see patients with prolactinomas and non-prolactin-secreting intracranial tumors under their care. This report presents an interesting and rare case of a woman with end-stage renal disease, who presented with hallucinations and a suprasellar mass. Her symptoms and prolactin levels, however, did not improve with adherent, inpatient, dopamine agonist treatment. She was eventually palliated and demised shortly after compassionate discharge. It is imperative that physicians maintain a high index of suspicion of alternative diagnoses (such as metastatic disease or high-grade glioma) when hypothalamic masses and raised prolactin levels do not significantly decline with dopamine agonism.