Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2021; 9(1): 190-196
Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.190
Hyperprolactinemia due to pituitary metastasis: A case report
Chun-Yang Liu, Yu-Bo Wang, Hui-Qin Zhu, Jin-Liang You, Zhuang Liu, Xian-Feng Zhang
Chun-Yang Liu, Yu-Bo Wang, Zhuang Liu, Xian-Feng Zhang, Department of Neurosurgery, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Hui-Qin Zhu, Department of Respiratory medicine, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Jin-Liang You, Department of Neurosurgery, Linyi Cancer Hospital, Linyi 276000, Shandong Province, China
Author contributions: Liu CY, Wang YB, and Zhu HQ contributed equally to this work; Liu CY, Zhang XF, and Wang YB diagnosed the patient; Liu CY and Zhu HQ analyzed the literature data; All authors wrote and revised the manuscript and issued the final approval for the version to be submitted.
Informed consent statement: Informed written consent has been obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian-Feng Zhang, PhD, Professor, Department of Neurosurgery, First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, Jilin Province, China. m13086818248@163.com
Received: May 23, 2020
Peer-review started: May 23, 2020
First decision: September 14, 2020
Revised: October 17, 2020
Accepted: November 9, 2020
Article in press: November 9, 2020
Published online: January 6, 2021
Processing time: 222 Days and 21.8 Hours
Abstract
BACKGROUND

Pituitary metastasis is an uncommon manifestation of systemic malignant tumors. Moreover, hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are rare.

CASE SUMMARY

A 53-year-old male patient was admitted to our hospital with complaints of bilateral blurred vision, dizziness, polyuria, nocturia, severe fatigue and somnolence, decreased libido, and intermittent nausea and vomiting for more than 6 mo. During the last 7 d, the dizziness had worsened. Laboratory investigations revealed overall hypofunction of the pituitary gland, but the patient had an elevated serum prolactin level (703.35 mg/mL). Preoperative magnetic resonance imaging revealed a tumor in the sellar region, accompanied by intratumoral hemorrhage and calcification. Thus, transnasal subtotal resection of the lesion in the sellar region was performed. The histopathological and immunohistochemical examinations of the resected lesion revealed metastasis of lung adenocarcinoma to the pituitary gland. Oral hydrocortisone (30 mg/d) and levothyroxine (25 mg/d) were given both pre- and postoperatively. Post-operatively, the clinical symptoms were significantly improved. However, 4 mo following the surgery, the patient succumbed due to multiple organ failure.

CONCLUSION

Hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma that metastasizes to the pituitary gland. Exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving quality of life.

Keywords: Hyperprolactinemia; Neoplasm metastasis; Pituitary neoplasms; Diagnosis; Treatment; Case report

Core Tip: Pituitary metastasis is an uncommon manifestation of systemic malignant tumors. Moreover, hyperprolactinemia and overall hypopituitarism caused by metastatic spread leading to the initial symptoms are very rare. We report a rare case of hyperprolactinemia caused by pituitary metastasis of lung adenocarcinoma and reviewed the relevant literature. We found that hyperprolactinemia is one of the markers of poor prognosis in patients with carcinoma metastatic to the pituitary gland, and exogenous hormone supplementation plays a positive role in relieving the symptoms of patients and improving their quality of life.