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[Invasive giant prolactinoma]

L J Domínguez Ugidos1, J Martínez Subías, A Urpegui García

  • 1Servicio de ORL, Hospital Clínico Universitario, Zaragoza.

Acta Otorrinolaringologica Espanola
|July 3, 1998
PubMed
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This case study highlights a rare, large, invasive prolactinoma presenting with skull base destruction and unusual symptoms. Medical management with bromocriptine showed partial tumor response, underscoring the complexity of these aggressive pituitary tumors.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Large prolactin-secreting pituitary tumors (prolactinomas) are uncommon.
  • Their management presents significant endocrinological and surgical challenges due to potential invasiveness.

Observation:

  • A patient presented with a large, invasive sphenoidal region tumor causing bone destruction and extending extracranially.
  • Initial symptoms included unilateral tinnitus and ear blockage, atypical for such a large skull base tumor.
  • Serum prolactin levels were markedly elevated at 16,860 ng/ml.

Findings:

  • Medical treatment with bromocriptine effectively lowered prolactin levels to 31 ng/ml.
  • Bromocriptine also induced tumor size reduction, though less than anticipated, indicating partial treatment response.

Related Experiment Videos

  • The tumor demonstrated aggressive invasion into surrounding skull base structures.

    • Implications:

    • This case underscores the rarity and aggressive nature of giant invasive prolactinomas.
    • It highlights the diagnostic challenge posed by atypical presentations of large pituitary tumors.
    • Effective, though potentially incomplete, medical management is demonstrated, necessitating tailored therapeutic strategies.