PMC6616046_01
H&E. x40. Cellular proliferation with weak nuclear pleomorphism.
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F1
Subsequently, the patient began treatment with bromocriptine 2.5 mg/day and underwent a transsphenoidal adenomectomy in April 1994 (Fig. 1), with a significant tumor burden after surgery.
H&E. x20. Osseous infiltration by the neoplasm.
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F2
Less than a year later, the patient reported lumbar pain, and an MRI scan showed a hypointense lesion in L1; a biopsy confirmed prolactinoma metastasis (Fig. 2, 3).
Immunohistochemistry for prolactin. x40. The image shows diffuse cytoplasmic expression and osseous infiltration by the neoplasm.
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F3
Less than a year later, the patient reported lumbar pain, and an MRI scan showed a hypointense lesion in L1; a biopsy confirmed prolactinoma metastasis (Fig. 2, 3).
Prolactin serum behavior 04/1994 to 12/2006.
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F4
Additionally, four transsphenoidal adenomectomies were needed in the consecutive years 2002, 2003, 2004, and 2005 due to recurrence of the sellar lesion with invasion to the carotid artery and with prolactin levels averaging 1,000 ng/mL (Fig. 4).