Abstract |
Aggressive giant invasive pituitary adenomas refractory to standard surgical or medical treatment remain a genuine challenge. In addition, communicating hydrocephalus (CH) attributed to malabsorption of cerebrospinal fluid (CSF) developing after radiotherapy for pituitary adenomas has not been previously reported. Herein, we describe the case of a 48-year-old male presenting with a giant atypical prolactinoma refractory to previous therapies, including pharmacotherapy and repetitive surgery. He underwent image-guided fractionated stereotactic radiotherapy in 28 fractions, resulting in early manifestation of CH associated with undisputed, both radiological and hormonal response. He recovered well after a shunt placement, with otherwise favorable consequences such as sustained tumor regression, decreasing prolactin level, and retained visual function for a 22-month follow-up. Fractionated stereotactic radiotherapy would provide a viable treatment alternative for these refractory cases, while caution should be exercised regarding the possibility of iatrogenic CH.
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Authors | Kazuhiro Ohtakara, Naoyuki Ohe, Toru Iwama, Hiroaki Hoshi |
Journal | Anticancer research
(Anticancer Res)
Vol. 34
Issue 5
Pg. 2509-15
(May 2014)
ISSN: 1791-7530 [Electronic] Greece |
PMID | 24778068
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Dose Fractionation, Radiation
- Humans
- Hydrocephalus
(etiology, surgery)
- Male
- Middle Aged
- Pituitary Neoplasms
(surgery)
- Prolactinoma
(surgery)
- Radiosurgery
(adverse effects)
- Ventriculoperitoneal Shunt
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