Macroprolactinomas presenting as nasal polyps: a series of three cases.
BACKGROUND
Pituitary tumours that present with nasal symptoms are uncommon. Management can be difficult due to their aggressive nature, location and extension.


METHODS
We report a series of three cases of prolactinomas that enlarged inferiorly presenting initially as nasal polyps.


RESULTS
Recurrence of symptoms (case 1) prompted testing for serum prolactin and examination of histology confirmed the presence of a prolactinoma. In cases 2 and 3, radiological evidence of a pituitary mass prompted testing for a prolactinoma. No patients exhibited clinical signs of hyperprolactinaemia. All three cases have residual tumour at 2-4 years after diagnosis, despite prolactin levels approaching the normal range on dopaminergic therapy.


CONCLUSIONS
Pituitary tumours that invade the nasal cavity are rare and clinicians should be aware of their existence. A prolactinoma should be considered in the differential diagnosis of nasopharyngeal tumours. Measurement of serum prolactin can expedite a diagnosis and prevent delay of treatment with dopamine agonists.
Johnston
P C
PC
Regional Centre for Diabetes and Endocrinology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK.
Courtney
H C
HC
Hunter
S J
SJ
Mc Cance
D R
DR
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000077465:Cabergoline; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis*; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D010911:Pituitary Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D011388:Prolactin / Q000097:blood
D000970:Antineoplastic Agents; D004873:Ergolines; D011388:Prolactin; D000077465:Cabergoline