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Astafieva L.I.

Burdenko Neurosurgical Center

Chernov I.V.

Burdenko Neurosurgical Center

Kobyakov G.L.

Botkin Moscow Multidisciplinary Scientific Clinical Center

Trunin Yu.Yu.

Burdenko Neurosurgical Center

Shishkina L.V.

Burdenko Neurosurgical Center

Shkarubo A.N.

Russian Medical Academy of Continuous Professional Education

Fomichev D.V.

Burdenko Neurosurgical Center

Sidneva Yu.G.

Research Institute of Emergency Pediatric Surgery and Traumatology

Vagapova G.R.

Kazan State Medical Academy

Kalinin P.L.

Burdenko Neurosurgical Center

Prolactin-secreting pituitary carcinomas with intra- and extracranial metastasis: case report and review

Authors:

Astafieva L.I., Chernov I.V., Kobyakov G.L., Trunin Yu.Yu., Shishkina L.V., Shkarubo A.N., Fomichev D.V., Sidneva Yu.G., Vagapova G.R., Kalinin P.L.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2025;89(1): 83‑93

DOI: 10.17116/neiro20258901183

Views: 613

Downloaded: 34

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Table of contents

PROLACTIN-SECRETING PITUITARY CARCINOMAS WITH INTRA- AND EXTRACRANIAL METASTASIS: CASE REPORT AND REVIEW
PROLACTIN-SECRETING PITUITARY CARCINOMAS WITH INTRA- AND EXTRACRANIAL METASTASIS: CASE REPORT AND REVIEW

To cite this article:

Astafieva LI, Chernov IV, Kobyakov GL, et al. . Prolactin-secreting pituitary carcinomas with intra- and extracranial metastasis: case report and review. Burdenko's Journal of Neurosurgery. 2025;89(1):83‑93. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20258901183

 
Подписка 2025-2 (Burdenko's Journal of Neurosurgery)
 
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Recommended articles:
Aggressive pituitary tumors and carcinomas: modern classification, adva­nces and prospects in treatment. Burdenko's Journal of Neurosurgery. 2024;(3):103-110

According to the modern WHO classification, pituitary carcinomas (or metastatic neuroendocrine pituitary tumors) are pituitary tumors with confirmed craniospinal and/or distant metastases. The main goal of histological analysis of pituitary carcinomas is to confirm pituitary origin of metastases. Treatment usually includes surgery and radiotherapy, dopamine agonists in maximum possible doses in case of prolactin-secreting pituitary carcinomas and chemotherapy with preferable temozolomide.

OBJECTIVE

To present the results of diagnosis and treatment of two patients with prolactin-secreting pituitary carcinomas.

MATERIAL AND METHODS

The authors describe 2 patients with prolactin-secreting pituitary carcinomas arising from drug-resistant aggressive prolactinomas with histologically confirmed metastases. In both cases, combined treatment included surgery, radio- and chemotherapy (cabergoline and temozolomide).

RESULTS

A 47-year-old patient underwent surgery, radio- and dopamine agonist therapy with subsequent regression of tumor growth in the follow-up period. However, progressive increase in prolactin concentration necessitated PET/CT with detection of multiple metastases in bones and lymph nodes. Temozolomide therapy led to temporary shrinkage of metastatic foci with subsequent progression. The second case was characterized by multiple brain and spinal cord metastases in a 47-year-old woman. Resection of intracranial metastasis and temozolomide therapy stabilized the disease and normalized serum prolactin throughout 2-year follow-up with subsequent progression.

CONCLUSION

Pituitary carcinoma is a rare tumor with unfavorable prognosis. Treatment is currently not standardized and determined by available world experience regarding various chemotherapeutic drugs. Temozolomide is the most effective drug. However, short-term remission is usually followed by subsequent disease progression in most cases.

Keywords:

aggressive pituitary tumor
prolactinoma
pituitary carcinoma
pituitary neuroendocrine tumor
temozolomide

Authors:

Astafieva L.I.

Burdenko Neurosurgical Center

Chernov I.V.

Burdenko Neurosurgical Center

Kobyakov G.L.

Botkin Moscow Multidisciplinary Scientific Clinical Center

Trunin Yu.Yu.

Burdenko Neurosurgical Center

Shishkina L.V.

Burdenko Neurosurgical Center

Shkarubo A.N.

Russian Medical Academy of Continuous Professional Education

Fomichev D.V.

Burdenko Neurosurgical Center

Sidneva Yu.G.

Research Institute of Emergency Pediatric Surgery and Traumatology

Vagapova G.R.

Kazan State Medical Academy

Kalinin P.L.

Burdenko Neurosurgical Center

Received:

01.08.2024

Accepted:

21.11.2024

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