Giant Prolactinoma Causing Hydrocephalus and Intracranial Hypertension as First Manifestations of Multiple Endocrine Neoplasia Type 1

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art_DANTAS_Giant_Prolactinoma_Causing_Hydrocephalus_and_Intracranial_Hypertension_as_2019.PDF (881.54 KB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2019
Editora
FRONTIERS MEDIA SA
DOI
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Scopus
Web of Science
Título da Revista
ISSN da Revista
Título do Volume
Autores
DANTAS, Naiara C. B.
SOARES, Carlos E. L.
MARTINS, Manoel R. A.
QUIDUTE, Ana R. P.
Autor de Grupo de pesquisa
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Organizadores
Citação
FRONTIERS IN ENDOCRINOLOGY, v.10, article ID 582, 9p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Context: Overall, giant prolactinomas are rare tumors (4%), especially those larger than 60 mm (1%). Despite the predominance of macroadenoma documented in multiple endocrine neoplasia type 1 (MEN1)-related prolactinoma, only three giant prolactinoma cases were described so far (size > 40 mm and prolactin > 1,000 ng/mL). None of them was larger than 60 mm or presented hydrocephalus or intracranial hypertension (ICH) as initial manifestation of MEN1. Case Description: A 21-years-old man presented with ICH as the first clinical manifestation of MEN1. He harbored a MEN1 germline mutation but refused periodic vigilance after normal hormonal screening at age 14 years. During investigation, magnetic resonance imaging (MRI) of the skull showed an expansive sellar/parasellar lesion (75 x 44 x 36 mm) with moderate to severe supratentorial obstructive hydrocephalus and an extremely high serum prolactin (PRL) of 10,800 ng/mL, without combined hypersecretion of other pituitary hormones. He was diagnosed with giant prolactinoma, and cabergoline was initiated. The patient evolved with early improvement of clinical complaints for hydrocephalus and ICH and PRL reached normal values (11 ng/mL) in association with significant tumoral shrinkage after 18 months on cabergoline. After 2 months of cabergoline, cerebrospinal fluid leakage was diagnosed and corrective surgery was provided. The mean dose of cabergoline was 3 mg/week throughout treatment. Conclusion: We reported the first case with hydrocephalus and ICH as the initial clinical manifestation of a giant prolactinoma in MEN1. From our knowledge, this is the largest MEN1-related prolactinoma reported so far. Notably, all four MEN1-related giant prolactinomas cases reported were younger than 21 years strengthening the importance to routine MEN1 genetic testing for prolactinoma in this age group. Also, they all had initial effective response with dopamine agonist ensuring this drug as first-line treatment for MEN1-related giant prolactinoma. However, the scarce number of treated patients and progression of cabergoline resistance in two of them suggest strict surveillance.
Palavras-chave
giant prolactinoma, dopaminergic agonist, pituitary adenoma, obstructive hydrocephalus, intracranial hypertension, multiple endocrine neoplasia type 1
URI
https://observatorio.fm.usp.br/handle/OPI/33613
Referências
  1. Acharya SV, 2010, ENDOCR PRACT, V16, P42, DOI 10.4158/EP09221.OR
  2. Acharya SV, 2009, PITUITARY, V12, P186, DOI 10.1007/s11102-008-0149-8
  3. Alkatari S, 2012, CLIN MED INSIGHT-CAS, V5, P115, DOI 10.4137/CCRep.S9675
  4. Cackett P, 2012, FUTURE ONCOL, V8, P1621, DOI [10.2217/FON.12.149, 10.2217/fon.12.149]
  5. Cannavo S, 2003, CLIN ENDOCRINOL, V58, P519, DOI 10.1046/j.1365-2265.2003.01748.x
  6. Carvalho RA, 2018, EUR J ENDOCRINOL, V179, P391, DOI 10.1530/EJE-18-0430
  7. Chattopadhyay Arijit, 2005, Pituitary, V8, P147, DOI 10.1007/s11102-005-5111-4
  8. Chentli Farida, 2015, Indian J Endocrinol Metab, V19, P359, DOI 10.4103/2230-8210.152771
  9. Colao A, 1998, J CLIN ENDOCR METAB, V83, P2777, DOI 10.1210/jc.83.8.2777
  10. Cuny T, 2013, EUR J ENDOCRINOL, V168, P533, DOI 10.1530/EJE-12-0763
  11. de Laat JM, 2015, J CLIN ENDOCR METAB, V100, P3288, DOI 10.1210/JC.2015-2015
  12. Delgrange E, 2014, EUR J ENDOCRINOL, V170, P31, DOI 10.1530/EJE-13-0503
  13. Drori-Herishanu L, 2009, HORM METAB RES, V41, P630, DOI 10.1055/s-0029-1216358
  14. Falchetti A, 2017, F1000RESEARCH, V6, P73, DOI 10.12688/F1000RESEARCH.7230.1
  15. Gan HW, 2015, INT J PEDIATR ENDOCR, DOI 10.1186/s13633-015-0011-5
  16. Gillam MP, 2006, ENDOCR REV, V27, P485, DOI 10.1210/er.2005-9998
  17. Goudet P, 2015, J CLIN ENDOCR METAB, V100, P1568, DOI 10.1210/jc.2014-3659
  18. Goudet P, 2010, WORLD J SURG, V34, P249, DOI 10.1007/s00268-009-0290-1
  19. GREBE SKG, 1992, NEW ZEAL MED J, V105, P129
  20. Hoffmann A, 2018, EUR J PEDIATR, V177, P125, DOI 10.1007/s00431-017-3042-5
  21. Iglesias P, 2004, AGE AGEING, V33, P410, DOI 10.1093/ageing/afh108
  22. Iglesias P, 2018, HORM METAB RES, V50, P791, DOI 10.1055/a-0752-0741
  23. LABAUGE R, 1982, REV NEUROL, V138, P149
  24. Lemos MC, 2008, HUM MUTAT, V29, P22, DOI 10.1002/humu.20605
  25. Liu Y, 2015, CHILD NERV SYST, V31, P909, DOI 10.1007/s00381-015-2679-5
  26. Lourenco DM, 2008, EUR J ENDOCRINOL, V159, P259, DOI 10.1530/EJE-08-0153
  27. Maiter D, 2014, EUR J ENDOCRINOL, V170, pR213, DOI 10.1530/EJE-14-0013
  28. Mascarell S, 2007, PITUITARY, V10, P95, DOI 10.1007/s11102-007-0009-y
  29. Moraes AB, 2013, CLIN ENDOCRINOL, V79, P447, DOI 10.1111/cen.12242
  30. Muniz Lourenco D, 2007, CLINICS, V62, P465, DOI 10.1590/S1807-59322007000400014
  31. MURPHY FY, 1987, AM J MED, V83, P995, DOI 10.1016/0002-9343(87)90668-1
  32. OBrien T, 1996, NEUROSURGERY, V39, P273, DOI 10.1097/00006123-199608000-00008
  33. Oiwa A, 2002, ENDOCR J, V49, P635, DOI 10.1507/endocrj.49.635
  34. PERANI D, 1984, J COMPUT ASSIST TOMO, V8, P131, DOI 10.1097/00004728-198402000-00027
  35. Rodrigues KC, 2017, THYROID, V27, P693, DOI 10.1089/thy.2016.0148
  36. Saeki N, 1998, ENDOCR J, V45, P529, DOI 10.1507/endocrj.45.529
  37. Salenave S, 2015, J CLIN ENDOCR METAB, V100, P1177, DOI 10.1210/jc.2014-3670
  38. Sarkar PK, 2001, AGE AGEING, V30, P426, DOI 10.1093/ageing/30.5.426
  39. Scarone P, 2006, J NEURO-ONCOL, V76, P51, DOI 10.1007/s11060-005-2319-0
  40. Schofl Christof, 2002, Pituitary, V5, P261, DOI 10.1023/A:1025334001748
  41. Shimon I, 2016, PITUITARY, V19, P429, DOI 10.1007/s11102-016-0723-4
  42. Shrivastava RK, 2002, J NEUROSURG, V97, P299, DOI 10.3171/jns.2002.97.2.0299
  43. Steele CA, 2010, EUR J ENDOCRINOL, V163, P515, DOI 10.1530/EJE-10-0519
  44. Stratakis CA, 2010, CLIN GENET, V78, P457, DOI 10.1111/j.1399-0004.2010.01406.x
  45. Subasinghe CJ, 2018, CASE REP ENDOCRINOL, DOI 10.1155/2018/2875074
  46. Tasma H, 2011, ACTA ENDOCRINOL-COP, V7, P95, DOI [10.4183/aeb.2011.95, DOI 10.4183/AEB.2011.95]
  47. Teh BT, 1998, J CLIN ENDOCR METAB, V83, P2621, DOI 10.1210/jc.83.8.2621
  48. Thakker RV, 2012, J CLIN ENDOCR METAB, V97, P2990, DOI 10.1210/jc.2012-1230
  49. Toledo RA, 2007, CLIN ENDOCRINOL, V67, P377, DOI 10.1111/j.1365-2265.2007.02895.x
  50. Vannucci L, 2018, ENDOCRINE, V59, P438, DOI 10.1007/s12020-017-1322-5
  51. Verges B, 2002, J CLIN ENDOCR METAB, V87, P457, DOI 10.1210/jc.87.2.457
  52. Wu ZB, 2006, J NEUROSURG, V104, P54, DOI 10.3171/jns.2006.104.1.54
  53. Yu Chonjiang, 2005, Pituitary, V8, P61, DOI 10.1007/s11102-005-5087-0
  54. Zikel OM, 1999, MAYO CLIN PROC, V74, P475

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - LIM/25