Multiple intracranial recurrent tumors with hyperprolactinemia combined with a parasellar malignant fibrous histiocytoma long after transfrontal surgery and irradiation to a pituitary adenoma

We herein describe a 40-year-old woman with hyperprolactinemia, an empty se lla and two extrasellar intracranial recurrent tumors which were revealed 2 3 years after the first transfrontal craniotomy and 18 years after the seco nd transfrontal surgery and irradiation to a provable prolactin-producing p ituitary macroadenoma. One recurrent tumor was in the right orbital apex ca using right oculomotor nerve palsy, and the other tumor was in the right ap ex partispetrosae and foramen jugulare. Although her serum prolactin level decreased after the administration of bromocriptine mesilate, and the size of the two tumors remained unchanged, a malignant fibrous histiocytoma, whi ch might have been induced by the irradiation 18 years before, grew rapidly in the right suprasellar-prepontine cistern to the right pedunculus cerebr alis, leading to a poor prognosis. This case confirmed the importance of th e life-lasting follow-up of pituitary adenomas treated with surgery and/or irradiation therapy. Not only ectopic recurrence of the primary tumor but a lso post-irradiation tumors may become apparent long after the removal of t he primary tumor. (J. Endocrinol. Invest. 24: 448-453, 2001) (C) 2001, Edit rice Kurtis.