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Metastatic prolactinomas are an extremely rare type of neuroendocrine tumors, comprising <0.2% of all pituitary tumors. These tumors are typically associated with poor prognosis, with an average survival of 10 months. Temozolomide, an alkylating chemotherapy agent, has previously been shown to be effective in treating these rare cases once first-line medical and surgical therapies have failed. We present a patient with metastatic prolactinoma to the cerebellopontine angle, thoracic spine, and lumbar spine who has achieved 12 years of survival with clinical improvement and stabilization after 4 years of temozolomide therapy.