A case of giant prolactinoma, initially misdiagnosed as sinonasal neuroendocrine carcinoma

摘要: Abstract Giant prolactinomas are defined as pituitary tumors greater than 4 cm, often associated with very high prolactin level (> 1000 ng/mL). They relatively rare and can present differently from typical prolactinomas. be highly invasive, resulting in acute neurological complication at the time of presentation. We a case young woman giant prolactinoma initially misdiagnosed sinonasal neuroendocrine carcinoma. The presentation headache, ptosis impending brain herniation, requiring emergent ventriculostomy intubation, led to clinical suspicion more sinister diagnosis. Transnasal biopsy mass was consistent carcinoma, chemotherapy planned. Laboratory testing, however, revealed an elevated (27,400 ng/mL, after 1:100 dilution). Re-review pathology additional immunohistochemical staining requested confirmed diagnosis prolactinoma. After 5 months cabergoline treatment, has decreased 118 ng/mL. There been marked reduction tumor size almost complete resolution symptoms. Given their atypical potential for sharing common stains other neoplasms, extending into nasal cavity neoplasms which may develop this site. Accurate is imperative prevent unnecessary surgery and/or radiation ensure implementation dopamine agonist therapy.