Unilateral Exophtalmos Caused by an Invasive Giant ProlactinomaC

Abstract

We report the case of a 40-year-old male presenting with an unilateral exophtalmos due to a large tumoral mass invading the skull base. Magnetic resonance imaging (MRI) showed extension of a large tumour (8*6*6 cm) into the right orbit. Endocrine evaluation revealed elevated serum prolactin (PRL) levels (161 290 ng/mL, NR < 12.07) leading to the diagnosis of an invasive giant prolactinoma. Treatment with Bromocriptine resulted in rapid decrease of serum PRL (3 months after initiation of treatment), reduction of tumour size with improvement of the exophtalmos. With reference to this case, we review the features of invasive giant prolactinomas. We point out the use of Dopamine agonists in the treatment of prolactinomas with such atypical presentation.