Discovery of a pituitary adenoma following a gonadotropin-releasing hormone agonist in a patient with prostate cancer

International Journal of Urology : Official Journal of the Japanese Urological Association
Walid MassoudAlain Ruffion

Abstract

Gonadotropin-releasing hormone (GnRH) agonists have become the treatment of choice for locally advanced and metastatic prostate cancer. We report a case of prostate cancer in which this treatment led to severe symptoms of intracranial hypertension due to the concomitant presence of an asymptomatic functional pituitary adenoma. A 70-year-old white man was initially evaluated for a multifocal adenocarcinoma, Gleason score 6 (3+3) with perineural invasion suggesting an extracapsular extension. A conformational external beam radiation (74 Gy) with a concomitant GnRH agonist (leuprolide) was initiated. Almost 10 days after the administration of leuprolide the patient complained of visual disturbance, diplopia and other symptoms of intracranial hypertension. Magnetic resonance imaging (MRI) of the brain demonstrated a large sella mass lesion. To relieve the patient's symptoms, a transsphenoidal subtotal tumorectomy was necessary. The histopathological examination revealed an invasive gonadotroph pituitary adenoma. Two years later, there is no sign of progression either on his prostatic disease (prostate-specific antigen of 0.21 ng/mL) or on his pituitary disease (FSH, 4.7 UI/L, LH, 3.1 UI/L and total testosterone, 627 ng/dL) with val...Continue Reading

References

Jul 1, 1995·The Journal of Clinical Endocrinology and Metabolism·P Chanson, G Schaison
Aug 13, 2004·European Urology·Dorothea Weckermann, Rolf Harzmann

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Citations

Nov 17, 2010·International Journal of Urology : Official Journal of the Japanese Urological Association·Yusuke Ito
Dec 3, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Yasuo SasagawaHideaki Iizuka
Sep 29, 2015·Endocrine Reviews·Claire BrietPhilippe Chanson
Apr 10, 2021·Pituitary·Francisco J GuardaLisa B Nachtigall

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