Presenter

Claire Coire is a Staff Pathologist Trillium Health Partners

Author

Claire I. Coire1, David G. Munoz2, Mihaly Kis3

 1 Trillium Health Partners, Mississauga Hospital, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto ON Canada.

2 Unity Health Toronto, St. Michael’s Hospital and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada

3 Trillium Health Partners, Mississauga Hospital and Division of Neurosurgery, University of Toronto, Toronto, ON Canada

Abstract

This 36-year-old female was referred for surgical management of a left-sided sellar mass presumed to be a prolactinoma. The patient had presented with headaches. She had been amenorrheic but had not experienced galactorrhea.  There had been biochemical evidence of elevated prolactin levels in the 50-60 μg/L. She had been given a trial of dopamine agonist therapy initially Dostinex and subsequently bromocriptine, neither of which she could tolerate.

The preoperative MRI imaging of the sella had shown increase in size of the adenoma from 6 mm to 9 mm.

Discussion points

  1. Differential diagnosis?
  2. What further test could be considered to refine the diagnosis?

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