J Neurol Surg B 2020; 81(01): 022-029
DOI: 10.1055/s-0039-1677678
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Calcified Prolactinoma of the Pituitary Gland: Illustrative Case Reports Highlighting Medical versus Surgical Intervention

Sherwin Tavakol
1  Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Asma Hasan
2  Division of Endocrinology and Diabetes, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Michelle A. Wedemeyer
1  Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Joshua Bakhsheshian
1  Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Chia-Shang J. Liu
3  Division of Neuroradiology, Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Mark S. Shiroishi
3  Division of Neuroradiology, Department of Radiology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Anna Mathew
4  Department of Pathology, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
John D. Carmichael
2  Division of Endocrinology and Diabetes, University of Southern California Keck School of Medicine, Los Angeles, California, United States
,
Gabriel Zada
1  Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, United States
› Author Affiliations
Funding Statement No funding sources to declare.
Further Information

Publication History

19 July 2018

15 December 2018

Publication Date:
05 February 2019 (online)

Abstract

The presence of calcification is uncommon in pituitary adenomas, and often lends support to other diagnoses including craniopharyngioma. The majority of calcified pituitary adenomas are prolactin-secreting tumors. We report two patients with calcified macroprolactinomas, one that was treated medically with a biochemical response and partial tumor response, and one that was treated successfully via an endoscopic endonasal transsphenoidal approach. Suspected calcified prolactinomas can be initially managed medically as per standard treatment for typical prolactinomas; however, the presence of diffuse calcification may hinder tumor shrinkage. Tumors that are refractory to medical treatment can be safely managed with surgery.

Author Contributions and Acknowledgments

ST, AH, JB, and MAW contributed to the generation and editing of the manuscript. AM provided pathology images and interpretation. CJL and MS provided radiology images, interpretation, and editing of the manuscript. JC provided interpretation of biochemical measures in addition to editing of the manuscript. GZ provided surgical expertise in addition to editing of the manuscript.