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Aggressive giant prolactinoma: a case report
BACKGROUND: Managing treatment-resistant aggressive giant prolactinoma can be challenging, as the diagnosis is often complex, and treatment beyond dopamine agonists, surgery, and radiotherapy is limited. CASE PRESENTATION: A 21-year-old Malay woman first presented to our hospital at the age of 16 ye...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055719/ https://www.ncbi.nlm.nih.gov/pubmed/35488355 http://dx.doi.org/10.1186/s13256-022-03390-y |
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author | Borhan, Marisa Khatijah Tan, Florence Hui Sieng |
author_facet | Borhan, Marisa Khatijah Tan, Florence Hui Sieng |
author_sort | Borhan, Marisa Khatijah |
collection | PubMed |
description | BACKGROUND: Managing treatment-resistant aggressive giant prolactinoma can be challenging, as the diagnosis is often complex, and treatment beyond dopamine agonists, surgery, and radiotherapy is limited. CASE PRESENTATION: A 21-year-old Malay woman first presented to our hospital at the age of 16 years with 1-year history of reduced vision and 2 years of amenorrhea. Her baseline prolactin level was 255,894 µIU/mL with secondary hypogonadism, and pituitary magnetic resonance imaging revealed a giant prolactinoma (2.8 × 3.2 × 4.2 cm(3)) with suprasellar extension and optic chiasmal compression. She was initially treated with cabergoline, and reductions in the prolactin level and tumor mass were achieved, leading to vision improvement and resumption of normal menstruation. However, she developed recurrent tumor growth and hyperprolactinemia, causing relapse of symptoms, and she needed surgery. Eventually, despite three tumor debulking surgeries and escalation of cabergoline doses up to 1 mg/day, her tumor progressed with aggressive characteristics. Following a multidisciplinary meeting, the patient is initiated on temozolomide therapy after considering the long-term side effects of radiotherapy in her case. CONCLUSION: This case highlights the importance of early identification of treatment-resistant prolactinoma and the need for a multidisciplinary approach in managing aggressive prolactinoma in young patients, particularly regarding timely implementation of temozolomide therapy. |
format | Online Article Text |
id | pubmed-9055719 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-90557192022-05-01 Aggressive giant prolactinoma: a case report Borhan, Marisa Khatijah Tan, Florence Hui Sieng J Med Case Rep Case Report BACKGROUND: Managing treatment-resistant aggressive giant prolactinoma can be challenging, as the diagnosis is often complex, and treatment beyond dopamine agonists, surgery, and radiotherapy is limited. CASE PRESENTATION: A 21-year-old Malay woman first presented to our hospital at the age of 16 years with 1-year history of reduced vision and 2 years of amenorrhea. Her baseline prolactin level was 255,894 µIU/mL with secondary hypogonadism, and pituitary magnetic resonance imaging revealed a giant prolactinoma (2.8 × 3.2 × 4.2 cm(3)) with suprasellar extension and optic chiasmal compression. She was initially treated with cabergoline, and reductions in the prolactin level and tumor mass were achieved, leading to vision improvement and resumption of normal menstruation. However, she developed recurrent tumor growth and hyperprolactinemia, causing relapse of symptoms, and she needed surgery. Eventually, despite three tumor debulking surgeries and escalation of cabergoline doses up to 1 mg/day, her tumor progressed with aggressive characteristics. Following a multidisciplinary meeting, the patient is initiated on temozolomide therapy after considering the long-term side effects of radiotherapy in her case. CONCLUSION: This case highlights the importance of early identification of treatment-resistant prolactinoma and the need for a multidisciplinary approach in managing aggressive prolactinoma in young patients, particularly regarding timely implementation of temozolomide therapy. BioMed Central 2022-04-30 /pmc/articles/PMC9055719/ /pubmed/35488355 http://dx.doi.org/10.1186/s13256-022-03390-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Borhan, Marisa Khatijah Tan, Florence Hui Sieng Aggressive giant prolactinoma: a case report |
title | Aggressive giant prolactinoma: a case report |
title_full | Aggressive giant prolactinoma: a case report |
title_fullStr | Aggressive giant prolactinoma: a case report |
title_full_unstemmed | Aggressive giant prolactinoma: a case report |
title_short | Aggressive giant prolactinoma: a case report |
title_sort | aggressive giant prolactinoma: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055719/ https://www.ncbi.nlm.nih.gov/pubmed/35488355 http://dx.doi.org/10.1186/s13256-022-03390-y |
work_keys_str_mv | AT borhanmarisakhatijah aggressivegiantprolactinomaacasereport AT tanflorencehuisieng aggressivegiantprolactinomaacasereport |