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Mawson Wang, Benjamin Jonker, Louise Killen, Yvonne Bogum, Ann McCormack and Ramy H Bishay

-line treatment for corticotroph tumours ( 4 ). Post-operative radiotherapy may be indicated for incomplete resection, local recurrence or persistent hormonal secretion, and this may occur in up to 20–30% of patients with Cushing’s disease ( 4 , 5 ). The

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Shamil D Cooray and Duncan J Topliss

with left thigh pain and right flank numbness. He had known progressive and widespread bony metastases, for which he has received palliative radiotherapy, and multiple bilateral asymptomatic pulmonary metastases. Progression of his bony metastatic

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J K Prague, C L Ward, O G Mustafa, B C Whitelaw, A King, N W Thomas and J Gilbert

respond rapidly to dopamine agonist therapy, but may require multimodal therapeutic options including surgery and radiotherapy to achieve normalisation of prolactin and tumour control (5) . Surgery may also be required if acute complications develop such

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Viral Chikani, Duncan Lambie and Anthony Russell

partial resection of the manubrium followed by radioactive iodine ablation. Over a period of 15 years, she received a further five courses of 131 I ablation, manubriumectomy in 2003 for a relapse of metastatic disease and radiotherapy to T1 vertebral

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Pia T Dinesen, Jakob Dal, Plamena Gabrovska, Mette Gaustadnes, Claus H Gravholt, Karen Stals, Judit Denes, Sylvia L Asa, Márta Korbonits and Jens O L Jørgensen

after diagnosis (b), 3 months after transcranial surgery (c), and 4 months after conventional radiotherapy (d). Almost 4 years elapsed between the first (a) and the last (d) MRI. The patient underwent transsphenoidal surgery; initial pathology

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Benedetta Zampetti, Giorgia Simonetti, Roberto Attanasio, Antonio Silvani and Renato Cozzi

to treatment with Cab, despite maximal dose titration, and these tumors are typically treated with surgery ( 3 ). Radiotherapy is occasionally required. In rare cases, prolactinomas may have or acquire an aggressive behavior, with uncontrolled tumor

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Anne de Bray, Zaki K Hassan-Smith, Jamal Dirie, Edward Littleton, Swarupsinh Chavda, John Ayuk, Paul Sanghera and Niki Karavitaki

these agents is rare and is often manifested with substantial increases in PRL levels and tumour enlargement ( 2 ). In cases non-responsive to DAs, the most commonly applied management options include changing to another DA, surgery and radiotherapy

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Fergus Keane, Aoife M Egan, Patrick Navin, Francesca Brett and Michael C Dennedy

radiotherapy to the prostate (74 Grey in 37 fractions). As outlined in Table 1 , this successfully reduced gonadotropin and testosterone concentrations. His prostate-specific antigen (PSA) levels were undetectable 12 months after indicating effective treatment

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S Hussain, E Panteliou, D M Berney, R Carpenter, M Matson, A Sahdev, M Bell, E O'Sullivan and W M Drake

disease. He received external beam flank radiotherapy, which resulted in a notable reduction in the residual tissue (3) , and almost 2 years later, he had no evidence of disease recurrence. Discussion This case is particularly interesting as there

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Marina Tsoli, Anna Angelousi, Dimitra Rontogianni, Constantine Stratakis and Gregory Kaltsas

developed brain and pulmonary metastases ten years after the initial diagnosis. Different chemotherapeutic regimens and radiotherapy did not prove to be of any benefit. Case presentation A 44-year-old woman presented with one-month history of