PURPOSE: Gonadotropin analogs like leuprolide play an important role in the management of prostate cancer. Pituitary apoplexy has been reported after leuprolide therapy. This report examines whether the presence of a pituitary tumor is a contraindication for leuprolide therapy in patients with prostate cancer. MATERIALS AND METHODS: Two patients with prostate cancer and pituitary tumors were treated with leuprolide and radiation therapy. The first patient with a previously unknown pituitary adenoma had a leuprolide injection for prostate gland downsizing prior to brachytherapy. The second patient with a known pituitary microadenoma had a biochemical recurrence and was treated with leuprolide and radiation therapy. RESULTS: The first patient developed symptoms of apoplexy a few hours after the leuprolide injection. He underwent a transsphenoidal resection of the sellar mass with complete neurologic recovery. The second patient did not have any adverse events after leuprolide with follow-up MRI scans showing no growth of the microadenomas. CONCLUSION: The presence of a pituitary tumor is not a contraindication for leuprolide therapy. While patients with a macroadenoma should have surgery first, those with a microadenoma may be considered for leuprolide therapy after careful evaluation by a multidisciplinary team.
PURPOSE: Gonadotropin analogs like leuprolide play an important role in the management of prostate cancer. Pituitary apoplexy has been reported after leuprolide therapy. This report examines whether the presence of a pituitary tumor is a contraindication for leuprolide therapy in patients with prostate cancer. MATERIALS AND METHODS: Two patients with prostate cancer and pituitary tumors were treated with leuprolide and radiation therapy. The first patient with a previously unknown pituitary adenoma had a leuprolide injection for prostate gland downsizing prior to brachytherapy. The second patient with a known pituitary microadenoma had a biochemical recurrence and was treated with leuprolide and radiation therapy. RESULTS: The first patient developed symptoms of apoplexy a few hours after the leuprolide injection. He underwent a transsphenoidal resection of the sellar mass with complete neurologic recovery. The second patient did not have any adverse events after leuprolide with follow-up MRI scans showing no growth of the microadenomas. CONCLUSION: The presence of a pituitary tumor is not a contraindication for leuprolide therapy. While patients with a macroadenoma should have surgery first, those with a microadenoma may be considered for leuprolide therapy after careful evaluation by a multidisciplinary team.
Authors: M Mercè Fernández-Balsells; Mohammad Hassan Murad; Amelia Barwise; Juan F Gallegos-Orozco; Anu Paul; Melanie A Lane; Julianna F Lampropulos; Inés Natividad; Lilisbeth Perestelo-Pérez; Paula G Ponce de León-Lovatón; Patricia J Erwin; Jantey Carey; Victor M Montori Journal: J Clin Endocrinol Metab Date: 2011-04 Impact factor: 5.958
Authors: Michel Bolla; Laurence Collette; Léo Blank; Padraig Warde; Jean Bernard Dubois; René-Olivier Mirimanoff; Guy Storme; Jacques Bernier; Abraham Kuten; Cora Sternberg; Johan Mattelaer; José Lopez Torecilla; J Rafael Pfeffer; Carmel Lino Cutajar; Alfredo Zurlo; Marianne Pierart Journal: Lancet Date: 2002-07-13 Impact factor: 79.321
Authors: Yannis Guerra; Evelyn Lacuesta; Francisco Marquez; P B Raksin; Manuel Utset; Leon Fogelfeld Journal: Pituitary Date: 2010 Impact factor: 4.107
Authors: Francisco J Guarda; Xiaoling Yu; Philip J Saylor; Lisa B Nachtigall; Naila Shiraliyeva; Melanie S Haines; Michael Bradbury Journal: Pituitary Date: 2021-04-09 Impact factor: 4.107
Authors: Rishi Raj; Ghada Elshimy; Aasems Jacob; P V Akhila Arya; Dileep C Unnikrishnan; Riccardo Correa; Zin W Myint Journal: J Cancer Res Clin Oncol Date: 2021-06-22 Impact factor: 4.553