{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:08:37Z","timestamp":1790366917852,"version":"4.1.0"},"reference-count":20,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pituitary carcinomas are rare but associated with significant morbidity and mortality. They remain challenging to diagnose and manage. In this case, we describe a 56-year-old man who presented with erectile dysfunction and binocular vertical diplopia. He had central hypogonadism, secondary adrenal insufficiency, and central hypothyroidism on biochemical testing. His serum prolactin was 1517 mcg\/L (1517 ng\/mL; reference range 4-15 mcg\/L), and his sellar magnetic resonance imaging showed a 2.0 \u00d7 2.2 \u00d7 3.1 cm pituitary tumor. Pathology revealed a prolactin-secreting carcinoma. Despite treatment with a high-dose dopaminergic, 2 transsphenoidal resections, and 1 course of radiation, prolactin levels continued to rise. He developed metastases to the epidural space and thecal sac from the thoracic to sacral spine, for which he received 12 cycles of temozolomide chemotherapy with initial clinical and biochemical response. This was followed by disease escape and progression. We discuss the clinical and imaging features that warrant a high index of suspicion for pituitary carcinoma and review contemporary treatment.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae047","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T07:45:49Z","timestamp":1713944749000},"source":"Crossref","is-referenced-by-count":1,"title":["A Rare Prolactin-secreting Pituitary Carcinoma With Epidural and Thecal Metastases"],"prefix":"10.1210","volume":"2","author":[{"given":"Anna","family":"Liu","sequence":"first","affiliation":[{"name":"Schulich School of Medicine and Dentistry, Western University , London, ON N6A 3K7 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan","family":"Van Uum","sequence":"additional","affiliation":[{"name":"Center for Diabetes, Endocrinology and Metabolism, St. Joseph's Health Care London , London, ON N6A 4V2 , Canada"},{"name":"Department of Medicine, Division of Endocrinology and Metabolism, Western University , London, ON N6A 5W9 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Western University , London, ON N6A 5A5 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R","family":"Hammond","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine and Department of Clinical Neurological Sciences, Western University , London, ON N6A 5A5 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Ezzat","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Site Group, Princess Margaret Cancer Centre , Toronto, ON M5G 2M9 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9636-5597","authenticated-orcid":false,"given":"Kristin K","family":"Clemens","sequence":"additional","affiliation":[{"name":"Center for Diabetes, Endocrinology and Metabolism, St. Joseph's Health Care London , London, ON N6A 4V2 , Canada"},{"name":"Department of Medicine, Division of Endocrinology and Metabolism, Western University , London, ON N6A 5W9 , Canada"},{"name":"Department of Epidemiology and Biostatistics, Western University , London, ON N6G 2M1 , Canada"},{"name":"Lawson Health Research Institute , London, ON N6C 2R5 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,4,24]]},"reference":[{"issue":"2","key":"2024052407035806500_luae047-B1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/s12022-019-9568-5","article-title":"An institutional experience of tumor progression to pituitary carcinoma in a 15-year cohort of 1055 consecutive pituitary neuroendocrine tumors","volume":"30","author":"Alshaikh","year":"2019","journal-title":"Endocr 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