PROLACTIN-SECRETING PITUITARY CARCINOMA WITH IMPLANTS IN THE CHEEK POUCH AND METASTASES TO THE OVARIES - A CASE-REPORT AND LITERATURE-REVIEW

Background. Prolactin-secreting pituitary carcinomas are uncommon, loc ally destructive neoplasms that rarely metastasize outside the central nervous system. The authors report a case of a prolactin-secreting tu mor that initially presented as the empty sella syndrome, Two recurren ces along transsphenoidal surgery tracts in cheek pouches were followe d by distant metastases later in the abdomen and pelvis. Only 10 previ ous cases of either extracranial or intracranial metastases from prola ctin-secreting pituitary carcinomas have been reported. No metastases below the diaphragm have been reported previously. Methods. The patien t's cheek pouch implants, lymph node metastases, ovarian metastases, a nd uterine metastases were studied with prolactin-specific immunohisto chemistry. Results. Long term treatment with bromocriptine, several de bulking surgeries, extensive local radiation therapy (external beam an d proton beam), and cytotoxic chemotherapy had little impact. Tamoxife n, however, may have slowed tumor growth. Conclusion. Tamoxifen may ha ve efficacy in the treatment of prolactin-secreting pituitary carcinom as.