Giant prolactinomas are rare tumors, representing only 2-3% of all prolactin (PRL)-secreting tumors. The management of giant prolactinomas remains a major challenge. Here we report the case of a young man aged 31 years old, followed up for a giant and invasive pituitary macroadenoma of 5cm discovered during a neuro-ophthalmic syndrome. The initial hormonal exploration and follow-up evaluation concluded hyperprolactinemia at 138.5ng/mL, anterior pituitary insufficiency and bilateral blindness related to optic atrophy. Incomplete surgical resection was performed after one month of medical treatment with a dopaminergic agonist. Histologic examination showed an aspect of an invasive macro-adenoma with no signs of malignancy. Despite therapeutic escalation, the evolution was marked by the persistence of resistant hyperprolactinemia. A control MRI was done showing a voluminous extra-axial expansive process measuring 9cm with significant anterolateral and inferior extension in the cavum and nasal fossae. A biopsy of the tumour in the nasal fossae was done showing morphological aspects and an immuno-histochemical profile of an aggressive lactotropic adenoma of the type "Acidophilic stem Cell adenoma" with an over expression of p53. External radiotherapy was indicated, but the patient died rapidly in a brain engagement table. This case illustrates the difficulty in the management and control of invasive and aggressive pituitary adenomas and their unpredictable course.
| Published in | World Journal of Medical Case Reports (Volume 1, Issue 1) |
| DOI | 10.11648/j.wjmcr.20200101.11 |
| Page(s) | 1-4 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Giant Prolactinoma, Pituitary Tumor, Cabergoline
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APA Style
Faten Hadj Kacem, Kawthar El Arbi, Abdalla Mrabet, Khouloud Boujelben, Souha Kallel, et al. (2020). Giant Macroadenoma with an Unusual Extension: A Case Report and Literature Review. World Journal of Medical Case Reports, 1(1), 1-4. https://doi.org/10.11648/j.wjmcr.20200101.11
ACS Style
Faten Hadj Kacem; Kawthar El Arbi; Abdalla Mrabet; Khouloud Boujelben; Souha Kallel, et al. Giant Macroadenoma with an Unusual Extension: A Case Report and Literature Review. World J. Med. Case Rep. 2020, 1(1), 1-4. doi: 10.11648/j.wjmcr.20200101.11
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Download@article{10.11648/j.wjmcr.20200101.11,
author = {Faten Hadj Kacem and Kawthar El Arbi and Abdalla Mrabet and Khouloud Boujelben and Souha Kallel and Slim Charfi and Mouna Elleuch and Ilhem Charfeddine and Taheya Boudawara and Mohamed Abid},
title = {Giant Macroadenoma with an Unusual Extension: A Case Report and Literature Review},
journal = {World Journal of Medical Case Reports},
volume = {1},
number = {1},
pages = {1-4},
doi = {10.11648/j.wjmcr.20200101.11},
url = {https://doi.org/10.11648/j.wjmcr.20200101.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20200101.11},
abstract = {Giant prolactinomas are rare tumors, representing only 2-3% of all prolactin (PRL)-secreting tumors. The management of giant prolactinomas remains a major challenge. Here we report the case of a young man aged 31 years old, followed up for a giant and invasive pituitary macroadenoma of 5cm discovered during a neuro-ophthalmic syndrome. The initial hormonal exploration and follow-up evaluation concluded hyperprolactinemia at 138.5ng/mL, anterior pituitary insufficiency and bilateral blindness related to optic atrophy. Incomplete surgical resection was performed after one month of medical treatment with a dopaminergic agonist. Histologic examination showed an aspect of an invasive macro-adenoma with no signs of malignancy. Despite therapeutic escalation, the evolution was marked by the persistence of resistant hyperprolactinemia. A control MRI was done showing a voluminous extra-axial expansive process measuring 9cm with significant anterolateral and inferior extension in the cavum and nasal fossae. A biopsy of the tumour in the nasal fossae was done showing morphological aspects and an immuno-histochemical profile of an aggressive lactotropic adenoma of the type "Acidophilic stem Cell adenoma" with an over expression of p53. External radiotherapy was indicated, but the patient died rapidly in a brain engagement table. This case illustrates the difficulty in the management and control of invasive and aggressive pituitary adenomas and their unpredictable course.},
year = {2020}
}
TY - JOUR T1 - Giant Macroadenoma with an Unusual Extension: A Case Report and Literature Review AU - Faten Hadj Kacem AU - Kawthar El Arbi AU - Abdalla Mrabet AU - Khouloud Boujelben AU - Souha Kallel AU - Slim Charfi AU - Mouna Elleuch AU - Ilhem Charfeddine AU - Taheya Boudawara AU - Mohamed Abid Y1 - 2020/09/03 PY - 2020 N1 - https://doi.org/10.11648/j.wjmcr.20200101.11 DO - 10.11648/j.wjmcr.20200101.11 T2 - World Journal of Medical Case Reports JF - World Journal of Medical Case Reports JO - World Journal of Medical Case Reports SP - 1 EP - 4 PB - Science Publishing Group SN - 2994-726X UR - https://doi.org/10.11648/j.wjmcr.20200101.11 AB - Giant prolactinomas are rare tumors, representing only 2-3% of all prolactin (PRL)-secreting tumors. The management of giant prolactinomas remains a major challenge. Here we report the case of a young man aged 31 years old, followed up for a giant and invasive pituitary macroadenoma of 5cm discovered during a neuro-ophthalmic syndrome. The initial hormonal exploration and follow-up evaluation concluded hyperprolactinemia at 138.5ng/mL, anterior pituitary insufficiency and bilateral blindness related to optic atrophy. Incomplete surgical resection was performed after one month of medical treatment with a dopaminergic agonist. Histologic examination showed an aspect of an invasive macro-adenoma with no signs of malignancy. Despite therapeutic escalation, the evolution was marked by the persistence of resistant hyperprolactinemia. A control MRI was done showing a voluminous extra-axial expansive process measuring 9cm with significant anterolateral and inferior extension in the cavum and nasal fossae. A biopsy of the tumour in the nasal fossae was done showing morphological aspects and an immuno-histochemical profile of an aggressive lactotropic adenoma of the type "Acidophilic stem Cell adenoma" with an over expression of p53. External radiotherapy was indicated, but the patient died rapidly in a brain engagement table. This case illustrates the difficulty in the management and control of invasive and aggressive pituitary adenomas and their unpredictable course. VL - 1 IS - 1 ER -
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