Cerebrospinal fluid rhinorrhea during treatment with bromocriptine for invasive giant prolactinoma.
- Author:
Abigail C LEJOS-CUREG
;
Aurora G MACABALLUG
;
Aimee ANDAG-SILVA
;
Bien J MATAWARAN
- Publication Type:Case report
- Keywords:
Giant Invasive ProlactinomaCerebrospinal Fluid RhinorrheaBromocriptine
- MeSH:
None
- From:
Philippine Journal of Internal Medicine
2008;46(2):83-85
- CountryPhilippines
- Language:English
-
Abstract:
CASE SUMMARY: A 41-year-old female, presented with a four-week history of blurring of vision with progressive bilateral visual failure accompanied by headache.Cranial MRI showed a sellar/suprasellar tumoral mass lesion measuring 6.2 x 5.3 x 6.8 cm extending to the basal frontal lobes, sphenoid sinus, planum sphenoidale, midbrain, pons, left cerebellar hemisphere, left side of vermis with extrinsic compression on the optic chiasm and 3rd ventricle producing obstructive hydrocephalus. Her serum prolactin was markedly elevated at 46,520 mg/mL. Treatment was started withbromocriptine 2.5 mg/tab at bedtime, increasing to 2.5 mg/tab every 8 hours.One week after discharge, patient was admitted because of cerebrospinal fluid (CSF) rhinorrhea and bacterial meningitis. She was treated with antibiotics and underwent packing of the sphenoid sinus. There was a recurrence of the CSF leak one week after packing, which then resolved spontaneously. The MRI scan performed after four months of bromocriptine therapy revealed a decrease in size of the sellar/suprasellar mass now measuring 4.3 x 3.7 x 5.2 cm and a significant drop in the prolactin level at 6.55 ng/mL.
