title: Ten-year follow-up of a giant prolactinoma.
abstract: Giant prolactinomas are rare pituitary tumours of which management can be a challenge. A 28-year-old man presented with headaches, visual impairment and behavioural changes. Clinically, the patient was found to have hypogonadism and bitemporal hemianopsia. A MRI demonstrated a pituitary tumour 76 mm in diameter and blood tests revealed a serum prolactin of 158,700 µU/mL (reference range 58-254). Initially, a craniotomy was performed. Immunohistochemistry of the tumour identified a prolactinoma with a high proliferative index and the patient was started on treatment with a dopamine agonist. A year later, neurological symptoms worsened due to regrowth of the lesion's cystic component, and so further surgery was performed. After 10 years of treatment with dopamine agonists, the prolactin levels decreased by 96.8%, there was an effective reduction in tumour size, and the neurological signs and symptoms resolved.
authors.affiliation: Department of Endocrinology, Hospital de Braga, Braga, Portugal.
authors.forename: Vera
authors.initials: V
authors.lastname: Fernandes
authors.affiliation: Department of Endocrinology, Hospital de Braga, Braga, Portugal.
authors.forename: Maria Joana
authors.initials: MJ
authors.lastname: Santos
authors.affiliation: Department of Neurosurgery, Hospital de Braga, Braga, Portugal Department of Pituitary Tumours Group, Hospital de Braga, Braga, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Almeida
authors.affiliation: Department of Endocrinology, Hospital de Braga, Braga, Portugal Department of Pituitary Tumours Group, Hospital de Braga, Braga, Portugal.
authors.forename: Olinda
authors.initials: O
authors.lastname: Marques
mesh_terms: D000328:Adult; D003399:Craniotomy; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004873:Ergolines / Q000627:therapeutic use; D005500:Follow-Up Studies; D006261:Headache / Q000175:diagnosis / Q000209:etiology; D006423:Hemianopsia / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D015354:Vision, Low / Q000175:diagnosis / Q000209:etiology
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D011388:Prolactin