# It Keeps Getting Bigger: A Patient With a Hypothalamic Tumor and Hyperprolactinemia

## TL;DR

A rare case of a patient with a hypothalamic tumor and high prolactin levels is described, where treatment with dopamine agonists failed to improve symptoms.

## Contribution

The paper highlights the importance of considering alternative diagnoses when dopamine agonist treatment for hyperprolactinemia fails.

## Key findings

- Dopamine agonist treatment did not reduce the patient's prolactin levels or symptoms.
- The case suggests the need to consider metastatic disease or high-grade glioma in similar clinical scenarios.
- The patient's condition was ultimately palliated and she passed away shortly after discharge.

## Abstract

Internists might occasionally see patients with prolactinomas and non-prolactin-secreting intracranial tumors under their care. This report presents an interesting and rare case of a woman with end-stage renal disease, who presented with hallucinations and a suprasellar mass. Her symptoms and prolactin levels, however, did not improve with adherent, inpatient, dopamine agonist treatment. She was eventually palliated and demised shortly after compassionate discharge. It is imperative that physicians maintain a high index of suspicion of alternative diagnoses (such as metastatic disease or high-grade glioma) when hypothalamic masses and raised prolactin levels do not significantly decline with dopamine agonism.