Presentation of a functional pituitary adenoma as a significant decrease in prostate-specific antigen level in a patient followed for prostate cancer.
The stimulatory role of testosterone in the production and release of prostate-specific antigen (PSA) has been well characterized. Testosterone production by the testes is dependent on a functional hypothalamic-pituitary-gonadal axis. High prolactin levels have been shown to disrupt this axis, resulting in decreases in gonadotropins and testosterone levels. We report a patient with prostate cancer and elevated PSA levels followed with "watchful waiting" for several years who experienced a precipitous decrease in PSA level over a 3 month period. The patient was found to have an asymptomatic prolactin-secreting pituitary macroadenoma.
Grotas
Aaron B
AB
Department of Urology, Beth-Israel Medical Center, Albert Einstein College of Medicine, New York, New York 10003, USA.
Nagler
Harris M
HM
D000230:Adenocarcinoma / Q000188:drug therapy / Q000378:metabolism; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000077465:Cabergoline; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D015175:Prolactinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000378:metabolism*
D000970:Antineoplastic Agents; D004873:Ergolines; D017430:Prostate-Specific Antigen; D000077465:Cabergoline