PMC9379538_01
T1WI by contrast enhanced MRI before, after the surgery and in the follow up. MRI before the surgery (A). One week after the surgery (B). Four months before HCQ and CAB combination treatment (C). Three months after HCQ and CAB combination treatment (D).
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Contrast enhanced magnetic resonance imaging (MRI) revealed a 2.0x2.7 cm mass in the sella, invading into the sphenoid sinus without surrounding the bilateral internal carotid arteries (Figure 1A). However, the postoperative PRL level of the patient was 1748.59 mIU/L and did not decrease to the normal level despite no residual tumour on MRI (Figure 1B). MRI showed no residual tumour (Figure 1C). Enhanced MRI continued to show no residual tumour (Figure 1D).
The blue line represented his PRL level in the 12-year following up and the purple line represented the upper limit of PRL normal range according to the hospitals where the blood was tested.
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Then, CAB was increased to 2 mg/week for 3 years and increased to 3 mg/week for 4 years; however, the patient's PRL level was never normalized (Figure 2). In the following three months, the PRL level remained within the normal range (Figure 2).