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• W2892854204 abstract "Objective: NA Background: Pituitary carcinomas are rare, representing up to 0.2% of pituitary tumors, with malignant prolactinomas constituting approximately one-third of cases. They often present with signs of abnormal hormone secretion (e.g. amenorrhea, galactorrhea) and symptoms of mass effect (e.g. visual changes, headache). Metastases can occur within the CNS, to bone and to visceral organs, however leptomeningeal metastases are quite rare. Mean survival is two years, with few case reports of long-term survivors. Design/Methods: NA Results: Case Description: A 52-year-old woman with a history of ductal carcinoma (2016, T1N0M0, ER+/PR+/Her2−, post partial mastectomy and XRT) on tamoxifen, and hyperprolactinemia (cabergoline 1990’s–2016) presented with two weeks of worsening left frontal headache and diplopia. Examination showed complete left oculomotor nerve paresis with no other cranial nerve deficits. Contrast- enhanced MRI of the brain showed a 12 mm non-enhancing cavernous sinus mass. Prolactin was elevated (287 ng/mL). FSH, LH, cortisol and IGF were normal. Repeat imaging showed tumor progression despite treatment with cabergoline and dexamethasone. Transphenoidal biopsy revealed atypical adenoma with elevated proliferative activity. Despite treatment with XRT and temozolomide, she developed dysphagia, and repeat MRI showed leptomeningeal dissemination with tumor deposits at the cervicomedullary junction, T- and L-spine, and bony metastases to multiple vertebral bodies indicative of transformation to carcinoma. She ultimately chose to pursue hospice care. Conclusions: Case Discussion: Leptomeningeal carcinomatosis from a malignant prolactinoma is exceedingly rare. Our case is particularly unusual for its origin from a presumed macroprolactinoma, the long latency between discovery of hyperprolactinemia and transformation to carcinoma, as well as dissemination along spinal fluid pathways. The risk of leptomeningeal carcinomatosis should be considered when planning diagnostic procedures and therapy for pituitary carcinoma. Disclosure: Dr. Cormier has nothing to disclose. Dr. Fisayo has nothing to disclose. Dr. Baehring has nothing to disclose. Dr. Becker has nothing to disclose." @default.
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• W2892854204 date "2018-04-10" @default.
• W2892854204 modified "2023-09-28" @default.
• W2892854204 title "Spinal Leptomeningeal Dissemination as a Fatal Complication of Malignant Prolactinoma (P6.094)" @default.
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