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Discovery of a pituitary adenoma following a gonadotropin-releasing hormone agonist in a patient with prostate cancer.
Int J Urol. 2006 Mar; 13(3):303-4.IJ

Abstract

Gonadotropin-releasing hormone (GnRH) agonists have become the treatment of choice for locally advanced and metastatic prostate cancer. We report a case of prostate cancer in which this treatment led to severe symptoms of intracranial hypertension due to the concomitant presence of an asymptomatic functional pituitary adenoma. A 70-year-old white man was initially evaluated for a multifocal adenocarcinoma, Gleason score 6 (3+3) with perineural invasion suggesting an extracapsular extension. A conformational external beam radiation (74 Gy) with a concomitant GnRH agonist (leuprolide) was initiated. Almost 10 days after the administration of leuprolide the patient complained of visual disturbance, diplopia and other symptoms of intracranial hypertension. Magnetic resonance imaging (MRI) of the brain demonstrated a large sella mass lesion. To relieve the patient's symptoms, a transsphenoidal subtotal tumorectomy was necessary. The histopathological examination revealed an invasive gonadotroph pituitary adenoma. Two years later, there is no sign of progression either on his prostatic disease (prostate-specific antigen of 0.21 ng/mL) or on his pituitary disease (FSH, 4.7 UI/L, LH, 3.1 UI/L and total testosterone, 627 ng/dL) with values of the hypothalamic-pituitary axis in the normal range. We advocate that a high index of suspicion of pituitary tumor must be considered in any case of intracranial hypertension following the administration of GnRH agonist. Abarelix could have a place in such cases.

Authors+Show Affiliations

Massoud W
Department of Urology, Lyon-Sud Hospital, Lyon, France.
Paparel P
No affiliation info available
Lopez JG
No affiliation info available
Perrin P
No affiliation info available
Daumont M
No affiliation info available
Ruffion A
No affiliation info available

MeSH

AdenocarcinomaAdenomaAgedAntineoplastic Agents, HormonalDiagnosis, DifferentialGonadotropin-Releasing HormoneHumansLeuprolideMagnetic Resonance ImagingMaleNeoplasms, Multiple PrimaryPituitary NeoplasmsProstatic NeoplasmsTomography, X-Ray Computed

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16643633

Citation

Massoud, Walid, et al. "Discovery of a Pituitary Adenoma Following a Gonadotropin-releasing Hormone Agonist in a Patient With Prostate Cancer." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 13, no. 3, 2006, pp. 303-4.
Massoud W, Paparel P, Lopez JG, et al. Discovery of a pituitary adenoma following a gonadotropin-releasing hormone agonist in a patient with prostate cancer. Int J Urol. 2006;13(3):303-4.
Massoud, W., Paparel, P., Lopez, J. G., Perrin, P., Daumont, M., & Ruffion, A. (2006). Discovery of a pituitary adenoma following a gonadotropin-releasing hormone agonist in a patient with prostate cancer. International Journal of Urology : Official Journal of the Japanese Urological Association, 13(3), 303-4.
Massoud W, et al. Discovery of a Pituitary Adenoma Following a Gonadotropin-releasing Hormone Agonist in a Patient With Prostate Cancer. Int J Urol. 2006;13(3):303-4. PubMed PMID: 16643633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Discovery of a pituitary adenoma following a gonadotropin-releasing hormone agonist in a patient with prostate cancer. AU - Massoud,Walid, AU - Paparel,Philippe, AU - Lopez,Jean-Gabriel, AU - Perrin,Paul, AU - Daumont,Michele, AU - Ruffion,Alain, PY - 2006/4/29/pubmed PY - 2006/10/6/medline PY - 2006/4/29/entrez SP - 303 EP - 4 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int J Urol VL - 13 IS - 3 N2 - Gonadotropin-releasing hormone (GnRH) agonists have become the treatment of choice for locally advanced and metastatic prostate cancer. We report a case of prostate cancer in which this treatment led to severe symptoms of intracranial hypertension due to the concomitant presence of an asymptomatic functional pituitary adenoma. A 70-year-old white man was initially evaluated for a multifocal adenocarcinoma, Gleason score 6 (3+3) with perineural invasion suggesting an extracapsular extension. A conformational external beam radiation (74 Gy) with a concomitant GnRH agonist (leuprolide) was initiated. Almost 10 days after the administration of leuprolide the patient complained of visual disturbance, diplopia and other symptoms of intracranial hypertension. Magnetic resonance imaging (MRI) of the brain demonstrated a large sella mass lesion. To relieve the patient's symptoms, a transsphenoidal subtotal tumorectomy was necessary. The histopathological examination revealed an invasive gonadotroph pituitary adenoma. Two years later, there is no sign of progression either on his prostatic disease (prostate-specific antigen of 0.21 ng/mL) or on his pituitary disease (FSH, 4.7 UI/L, LH, 3.1 UI/L and total testosterone, 627 ng/dL) with values of the hypothalamic-pituitary axis in the normal range. We advocate that a high index of suspicion of pituitary tumor must be considered in any case of intracranial hypertension following the administration of GnRH agonist. Abarelix could have a place in such cases. SN - 0919-8172 UR - https://www.unboundmedicine.com/medline/citation/16643633/Discovery_of_a_pituitary_adenoma_following_a_gonadotropin_releasing_hormone_agonist_in_a_patient_with_prostate_cancer_ DB - PRIME DP - Unbound Medicine ER -