PMC7371848_01
Serial changes in serum PRL levels from initial diagnosis to transsphenoidal surgery. PRL, prolactin; BCT, bromocriptine.
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F1
PRL levels continued to increase despite the escalation of bromocriptine doses, she underwent transsphenoidal surgery 2 years after. Prednisolone and levothyroxine was administered for postoperative panhypopituitarism, and DA was changed to cabergoline after surgery (Figure 1).
The change in sellar mass (A) 1-year after surgery (B) 3-years after surgery (C) 5-years after surgery. Although dramatic elevation of serum PRL levels were observed since Jun 2016, prominent sellar mass was detected on June 2018.
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F2
Sella MRI showed a 3.3-cm sized recurrent pituitary mass (Figure 2).
Serial changes in serum PRL levels from first surgery to second surgery. CBG, cabergoline.
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F3
Since serum PRL levels decreased to 33 ng/ml, she did not receive DA after the second surgery (Figure 3).
Histological characteristics of liver masses. Results of (A) Hematoxylin and eosin (B) PRL (C) Ki-67 index (D) p53 stain. PRL was strongly positive in liver masses indicating metastases from PRL-producing pituitary carcinoma, not from GIST.
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F4
Percutaneous biopsy showed that the liver masses were metastatic lesions from malignant prolactinoma and not from GIST (Figure 4).