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Untreated Giant Macroprolactinoma with Chronic Cerebrospinal Fluid Leakage: An Unusual Complication
Joint Authors
Mad Naser, Mohamad Nazrulhisham
Aziz, Nor Azizah
Karim, Noor Khairiah A.
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-01-15
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Macroprolactinoma has the potential to cause base of skull erosion and often extends into the sphenoid sinus.
Rapid shrinkage of this invasive tumor following dopamine agonist therapy has been postulated to cause unplugging of the eroded area, leading to cerebrospinal fluid leakage.
To the best of our knowledge, the occurrence of spontaneous cerebrospinal fluid leak in treatment-naive prolactinomas is very rare, the majority of which involve undiagnosed macroprolactinomas.
We describe here a lady presented late with giant macroprolactinoma, complicated by cerebrospinal fluid leakage.
This case raised the dilemma in the management pertaining to the role of either pharmacotherapy or surgical intervention, or combination of both.
As she strictly refused surgery, she was treated with bromocriptine which was later changed to cabergoline.
On follow-up, there was cessation of cerebrospinal fluid leak, marked reduction of serum prolactin level, and imaging evidence of tumor shrinkage.
The majority of patients with medically induced cerebrospinal fluid leakage will require surgical procedures to overcome this complication; however, there are isolated cases of leakage resolution on continuing dopamine agonist therapy while awaiting surgery.
The use of dopamine agonist does not necessarily cause worsening of cerebrospinal fluid leakage and instead may produce spontaneous resolution as in this case.
American Psychological Association (APA)
Mad Naser, Mohamad Nazrulhisham& Aziz, Nor Azizah& Karim, Noor Khairiah A.. 2019. Untreated Giant Macroprolactinoma with Chronic Cerebrospinal Fluid Leakage: An Unusual Complication. Case Reports in Endocrinology،Vol. 2019, no. 2019, pp.1-5.
https://search.emarefa.net/detail/BIM-1135746
Modern Language Association (MLA)
Mad Naser, Mohamad Nazrulhisham…[et al.]. Untreated Giant Macroprolactinoma with Chronic Cerebrospinal Fluid Leakage: An Unusual Complication. Case Reports in Endocrinology No. 2019 (2019), pp.1-5.
https://search.emarefa.net/detail/BIM-1135746
American Medical Association (AMA)
Mad Naser, Mohamad Nazrulhisham& Aziz, Nor Azizah& Karim, Noor Khairiah A.. Untreated Giant Macroprolactinoma with Chronic Cerebrospinal Fluid Leakage: An Unusual Complication. Case Reports in Endocrinology. 2019. Vol. 2019, no. 2019, pp.1-5.
https://search.emarefa.net/detail/BIM-1135746
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1135746