MULTIPLE INTRACRANIAL METASTASES FROM A PROLACTIN SECRETING PITUITARY TUMOUR

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Abstract
A 28 yr old man present with partial hypopituitarism and signs of a pituitary tumor. A chromophobe adenoma was partially removed by right frontal craniotomy. Seven years later complete hypopituitarism and hyperprolactinemia were documented, at which time there was no evidence of tumor recurrence on CT computed tomography scan. The patient was treated with bromocriptine but the pituitary tumor redeveloped a year later. Nine years after the original operation the 1st metastasis was demonstrated together with very high prolactin levels. The intracranial metastasis, and the pituitary tumor were removedat a 2nd craniotomy following which the prolactin concentration fell. Further metastases developed subsequently and the patient died 12 yr after the initial diagnosis. At autopsy multiple metastases were found in the brain, tumor cells were present in the subarachnoid space and in cerebral veins. The pituitary tumor and secondaries were shown by immunocytochemistry to contain prolactin but not ACTH or growth hormone. This appears to be the 3rd well documented case of a metastasizing, prolactin secreting pituitary tumor.