Ectopic pituitary adenomas (EPAs) are a rare clinical entity and are frequently mistaken for other base of skull lesions on imaging. We report the clinical presentation and management of a presenting with an ectopic prolactinoma located in the clivus. A 66-year-old female presented with a six-month history of headaches and light-headedness. Anatomical imaging demonstrated a clival lesion most suspicious for chordoma. Endocrinological assessment showed a modestly increased prolactin and gonadotrophins that were lower than expected for her age. Surgical resection confirmed an ectopic prolactinoma.
A skull base lesion in a patient with hormonal derangement should lend to a high clinical suspicion of an EPA as they may be treated with medications before surgery. There exists potential for a guideline to be created for the management of ectopic pituitary adenomas.