Volume 29, Issue 159, May 2025

When does prolactinoma require neurosurgical intervention?

Przemysław Kwiatka^1♦, Marta Borecka¹, Karolina Hanusz¹, Anna Bieda², Arkadiusz Zaremba³, Karolina Stachyra⁴, Julia Beata Krasnodębska⁵, Mateusz Leśniewski⁵, Michał Kluska⁶, Maciej Wyskok⁷

¹National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
²Masovian Bródnowski Hospital, Warsaw, Poland
³Scanmed Rudolf Weigl Hospital in Blachownia, Blachownia, Poland
⁴Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
⁵Czerniakowski Hospital, Stępińska 19/25, 00-739 Warsaw, Poland
⁶Samodzielny Publiczny Szpital Kliniczny im. prof. W. Orłowskiego CMKP, Czerniakowska, 231, 00-416 Warsaw, Poland
⁷Academy of Silesia, Rolna 43, 40-555 Katowice, Poland

^♦Corresponding author
Przemysław Kwiatka, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland

ABSTRACT

Patients with macroprolactinoma (MPRL) resistant to dopamine agonists and its rare complications, such as CSF rhinorrhea is rarely seen by physicians. This report presents a clinical case of a 51-year-old female with MPRL complicated by CSF leakage. She had been experiencing visual impairment and headaches for six months. The diagnosis of MPRL was made based on serum prolactin level and MRI images. After three months of cabergoline treatment, a follow-up MRI scan revealed tumor shrinkage. However, the patient developed CSF rhinorrhea, a severe complication requiring urgent surgical intervention. The main objective of the article is to discuss risk factors, diagnostic approaches, and therapeutic management of CSF rhinorrhea.

Keywords: CSF Rhinorrhea, Dopamine Agonist, Macroprolactinoma, Sellar Floor Erosion

Medical Science, 2025, 29, e70ms3554

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DOI: https://doi.org/10.54905/disssi.v29i158.e70ms3554

Published: 21 May 2025