A case of pediatric atypical prolactinoma: significance of a multidisciplinary treatment approach

•There are a small subset of atypical prolactinoma showing a rapid tumor growth and a high rate of recurrence in PRL-producing pituitary adenomas.•This non-benign phenotype shows high mitotic acitivity, high Ki-67 proliferative index >3% and positive immunoreactivity for p53.•Progressive intolerable headache and severe visual disturbance with rapid tumor growth should be kept in our minds as important clinical manifestations of atypical adenoma.•When an atypical phenotype of prolactinoma is suspected, histological verification of surgical specimens is essential before medical therapy with a dopamine agonist.