case_images: PMC7371848_01
case_images: Serial changes in serum PRL levels from initial diagnosis to transsphenoidal surgery. PRL, prolactin; BCT, bromocriptine.
case_images: fendo-11-00451-g0001.jpg
case_images: PMC7371848_01_fendo-11-00451-g0001.jpg
case_images: F1
case_images: PRL levels continued to increase despite the escalation of bromocriptine doses, she underwent transsphenoidal surgery 2 years after. Prednisolone and levothyroxine was administered for postoperative panhypopituitarism, and DA was changed to cabergoline after surgery (Figure 1).
case_images: The change in sellar mass (A) 1-year after surgery (B) 3-years after surgery (C) 5-years after surgery. Although dramatic elevation of serum PRL levels were observed since Jun 2016, prominent sellar mass was detected on June 2018.
case_images: fendo-11-00451-g0002.jpg
case_images: PMC7371848_01_fendo-11-00451-g0002.jpg
case_images: F2
case_images: Sella MRI showed a 3.3-cm sized recurrent pituitary mass (Figure 2).
case_images: Serial changes in serum PRL levels from first surgery to second surgery. CBG, cabergoline.
case_images: fendo-11-00451-g0003.jpg
case_images: PMC7371848_01_fendo-11-00451-g0003.jpg
case_images: F3
case_images: Since serum PRL levels decreased to 33 ng/ml, she did not receive DA after the second surgery (Figure 3).
case_images: Histological characteristics of liver masses. Results of (A) Hematoxylin and eosin (B) PRL (C) Ki-67 index (D) p53 stain. PRL was strongly positive in liver masses indicating metastases from PRL-producing pituitary carcinoma, not from GIST.
case_images: fendo-11-00451-g0004.jpg
case_images: PMC7371848_01_fendo-11-00451-g0004.jpg
case_images: F4
case_images: Percutaneous biopsy showed that the liver masses were metastatic lesions from malignant prolactinoma and not from GIST (Figure 4).