title: Giant prolactinomas presenting as skull base tumors.
abstract: BACKGROUND
  Prolactinomas invading the skull base are rare, and could easily be confused with skull base tumors of nonpituitary origin.
  
  
  METHODS
  We report a series of 4 cases of giant prolactinomas invading the skull base and presenting with atypical symptoms. Case 1 presented with a short history of headache and nasal obstruction. Case 2 presented with progressive hypoacusia, dizziness, and ophthalmoplegia. In Case 3, the patient developed rapid progressive visual failure and psychiatric symptoms. Case 4 presented with a 1-year history of headache and retrorbital pain. The diagnosis of prolactinoma was made on the basis of tumor immunohistochemistry and/or high plasma prolactin levels (range from 650-6,500 ng/mL). Medical treatment with the dopamine agonist cabergoline was given; it was effective in normalizing prolactin levels and inducing tumor shrinkage.
  
  
  CONCLUSIONS
  Prolactin levels should be measured in all large skull base tumors involving the pituitary region before any surgery or inappropriate radiotherapy is performed.
authors.affiliation: INM-IRCCS Neuromed, Pozzilli, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Minniti
authors.forename: Marie Lise
authors.initials: ML
authors.lastname: Jaffrain-Rea
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Esposito
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrante
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Cantore
mesh_terms: D000328:Adult; D000077465:Cabergoline; D003937:Diagnosis, Differential; D018491:Dopamine Agonists / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D019292:Skull Base Neoplasms / Q000175:diagnosis*
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D011388:Prolactin; D000077465:Cabergoline