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Symptomatic hyperprolactinemia from an ectopic pituitary adenoma located in the clivus.
Endocr Pract. 2009 Mar; 15(2):143-8.EP

Abstract

OBJECTIVE

To report a case of an ectopic pituitary adenoma in the clivus.

METHODS

The clinical, laboratory, and imaging findings of the case are reviewed, and the embryogenesis of the pituitary gland, the pathophysiologic features of this condition, the diagnosis, and the treatment options are discussed.

RESULTS

A 20-year-old man presented to a local physician because of a milky nipple discharge of 2 months' duration. He was otherwise healthy. Findings on physical examination were unremarkable except for the milky discharge from both nipples on expression. Serum prolactin, insulinlike growth factor-I, and alpha-fetoprotein were measured. Magnetic resonance imaging of the brain revealed a 13-mm erosive mass in the clivus. Surgical excision of the lesion was undertaken because of the propensity for aggressive lesions in this anatomic location and the high likelihood of complete resection. After the resected tissue was examined, the patient was diagnosed as having an ectopic prolactin-producing pituitary adenoma. His endocrinologic function normalized after resection, and no further therapy was needed.

CONCLUSION

Ectopic prolactinoma in the clivus is an uncommon lesion. Surgical resection was undertaken in our patient because of the uncertainty of the diagnosis and the aggressive natural history of more common tumors of the clivus, such as chordomas. Resection provided a cure in this patient. Although it is possible that a successful trial of dopaminergic therapy would have obviated surgical intervention, this approach would be associated with additional risks if the diagnosis were incorrect.

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Authors+Show Affiliations

Rocque BG
Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin 53792, USA.
Herold KA
No affiliation info available
Salamat MS
No affiliation info available
Shenker Y
No affiliation info available
Kuo JS
No affiliation info available

MeSH

Cranial Fossa, PosteriorHumansHyperprolactinemiaMagnetic Resonance ImagingMalePituitary NeoplasmsYoung Adult

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19289326

Citation

Rocque, Brandon G., et al. "Symptomatic Hyperprolactinemia From an Ectopic Pituitary Adenoma Located in the Clivus." Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, vol. 15, no. 2, 2009, pp. 143-8.
Rocque BG, Herold KA, Salamat MS, et al. Symptomatic hyperprolactinemia from an ectopic pituitary adenoma located in the clivus. Endocr Pract. 2009;15(2):143-8.
Rocque, B. G., Herold, K. A., Salamat, M. S., Shenker, Y., & Kuo, J. S. (2009). Symptomatic hyperprolactinemia from an ectopic pituitary adenoma located in the clivus. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 15(2), 143-8.
Rocque BG, et al. Symptomatic Hyperprolactinemia From an Ectopic Pituitary Adenoma Located in the Clivus. Endocr Pract. 2009;15(2):143-8. PubMed PMID: 19289326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptomatic hyperprolactinemia from an ectopic pituitary adenoma located in the clivus. AU - Rocque,Brandon G, AU - Herold,Kelly A G, AU - Salamat,M Shahriar, AU - Shenker,Yoram, AU - Kuo,John S, PY - 2009/3/18/entrez PY - 2009/3/18/pubmed PY - 2009/6/24/medline SP - 143 EP - 8 JF - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists JO - Endocr Pract VL - 15 IS - 2 N2 - OBJECTIVE: To report a case of an ectopic pituitary adenoma in the clivus. METHODS: The clinical, laboratory, and imaging findings of the case are reviewed, and the embryogenesis of the pituitary gland, the pathophysiologic features of this condition, the diagnosis, and the treatment options are discussed. RESULTS: A 20-year-old man presented to a local physician because of a milky nipple discharge of 2 months' duration. He was otherwise healthy. Findings on physical examination were unremarkable except for the milky discharge from both nipples on expression. Serum prolactin, insulinlike growth factor-I, and alpha-fetoprotein were measured. Magnetic resonance imaging of the brain revealed a 13-mm erosive mass in the clivus. Surgical excision of the lesion was undertaken because of the propensity for aggressive lesions in this anatomic location and the high likelihood of complete resection. After the resected tissue was examined, the patient was diagnosed as having an ectopic prolactin-producing pituitary adenoma. His endocrinologic function normalized after resection, and no further therapy was needed. CONCLUSION: Ectopic prolactinoma in the clivus is an uncommon lesion. Surgical resection was undertaken in our patient because of the uncertainty of the diagnosis and the aggressive natural history of more common tumors of the clivus, such as chordomas. Resection provided a cure in this patient. Although it is possible that a successful trial of dopaminergic therapy would have obviated surgical intervention, this approach would be associated with additional risks if the diagnosis were incorrect. SN - 1934-2403 UR - https://www.unboundmedicine.com/medline/citation/19289326/Symptomatic_hyperprolactinemia_from_an_ectopic_pituitary_adenoma_located_in_the_clivus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1530-891X(20)41023-7 DB - PRIME DP - Unbound Medicine ER -