Radiology Case Reports (Jun 2021)

Clival prolactinoma masquerading as a chordoma: a case report

  • Quynh Truong, MD,
  • Simon J. Ryder, MBBS,
  • Jennifer Gillespie, MBBS,
  • Jason Papacostas, MBBS,
  • Donald S.A. McLeod, MBBS

Journal volume & issue
Vol. 16, no. 6
pp. 1320 – 1324

Abstract

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Ectopic pituitary adenomas are a rare clinical entity and are frequently mistaken for other base of skull lesions on imaging. We report the clinical presentation and management of a woman presenting with an ectopic prolactinoma located in the clivus. A 66-year-old female presented with a 6-month history of headaches and light-headedness. Anatomical imaging demonstrated a clival lesion most suspicious for chordoma. Endocrinological assessment revealed modestly increased prolactin level with lower-than-expected gonadotrophins levels for her age. Surgical resection confirmed an ectopic prolactinoma.A skull base lesion in a patient with hormonal derangement should lend to a high clinical suspicion of an EPA as they may be treated with medications before surgery. Guidelines could assist clinicians investigating skull-based lesions to identify the rare, but important diagnosis of ectopic pituitary adenomas.

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