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.
Written by:
Babbo A, Kalapurakal GT, Liu B, Bajramovic S, Chandler JP, Garnett J, Kalapurakal JA. Are you the author?
Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St, LC 178, Chicago, IL, 60611, USA.
Reference: Int Urol Nephrol. 2014 Apr 6. Epub ahead of print.
doi: 10.1007/s11255-014-0708-z
PubMed Abstract
PMID: 24705727
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