Treatment of aggressive prolactinsecreting pituitary adenomas with adjuvant temozolomide chemotherapy

Abstract

Prolactin-secreting pituitary adenomas are typically slow growing and are mainly managed effectively with medical and/or surgical therapy. Very rarely, these tumors behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman that initially responded to dopamine agonist therapy, but over the course of 10 years, developed multiple recurrences of tumor growth which became progressively aggressive refractory to usual treatment modalities, but responded well to treatment with the chemotherapeutic agent Temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy and chemotherapy.