In 1970 a 20 year Mld woman presented with a pituitary chromophobe adenoma for which she underwent transfrontal pituitary surgery. In 1978 she had to be reope rated on because of local tumour recurrence, resulting in ...In 1970 a 20 year Mld woman presented with a pituitary chromophobe adenoma for which she underwent transfrontal pituitary surgery. In 1978 she had to be reope rated on because of local tumour recurrence, resulting in hypopituitarism. Bromo criptine (5 mg/day) was given for 15 years, but the plasma prolactin levels rema ined elevated. In 2000 the patient presented with signs and symptoms suggestive of a spinal cord lesion at the mid thoracic level. A magnetic resonance imaging (MRI) scan showed an extensive leptomeningeal mass extending from the brainstem to L5, with a thoracic syringomyelia at the T7 T8 level. The plasma prolactin level was very high (5114 μg/l). A biopsy showed the presence of a metastasised prolactinoma. On administration of high dose cabergoline, 0.5 mg twice a day or ally, the plasma prolactin levels decreased within one month and then normalised within 26 months. Tumour load reduced considerably but unfortunately, her signs and symptoms did not improve. This case illustrates that a high dose dopamine a gonist might be an important therapeutic option in patients with a metastasised prolactinoma.展开更多
文摘In 1970 a 20 year Mld woman presented with a pituitary chromophobe adenoma for which she underwent transfrontal pituitary surgery. In 1978 she had to be reope rated on because of local tumour recurrence, resulting in hypopituitarism. Bromo criptine (5 mg/day) was given for 15 years, but the plasma prolactin levels rema ined elevated. In 2000 the patient presented with signs and symptoms suggestive of a spinal cord lesion at the mid thoracic level. A magnetic resonance imaging (MRI) scan showed an extensive leptomeningeal mass extending from the brainstem to L5, with a thoracic syringomyelia at the T7 T8 level. The plasma prolactin level was very high (5114 μg/l). A biopsy showed the presence of a metastasised prolactinoma. On administration of high dose cabergoline, 0.5 mg twice a day or ally, the plasma prolactin levels decreased within one month and then normalised within 26 months. Tumour load reduced considerably but unfortunately, her signs and symptoms did not improve. This case illustrates that a high dose dopamine a gonist might be an important therapeutic option in patients with a metastasised prolactinoma.
