ReviewPituitary2018
Medically induced CSF rhinorrhea following treatment of macroprolactinoma: case series and literature review.
Review in Pituitary, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Risk factors of cerebrospinal fluid leakage after neuroendoscopic transsphenoidal pituitary adenoma resection: a systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Italian Guidelines for the Management of Prolactinomas.Endocrine, metabolic & immune disorders drug targets · 2023Guideline
- Chinese consensus on the diagnosis and treatment of prolactinomas (2025 edition).Chinese neurosurgical journal · 2026Review
- Ultra-rapid prolactin normalization with cabergoline in a premenopausal woman with epilepsy and giant prolactinoma.JCEM case reports · 2026Article
- Skull base reconstruction strategy for high-flow CSF leaks during EEA surgery based on the quality of pedicled nasoseptal flap.Scientific reports · 2026Article
- When treatment backfires: Dopamine agonist-induced CSF leaks in prolactinomas - Case series and systematic review.Brain & spine · 2026Review
- Cabergoline-induced cerebrospinal fluid fistulae in macroprolactinomas.Langenbeck's archives of surgery · 2025Article
- Giant prolactinoma with progressive cranial settling and central herniation: a case report.Journal of medical case reports · 2024Article
- Endoscopic endonasal surgery for prolactinomas: prognostic factors for disease control and management of persistent disease.Neurosurgical review · 2023Article
- A giant invasive macroprolactinoma with recurrent nasal bleeding as the first clinical presentation: case report and review of literature.BMC endocrine disorders · 2023Review
- Review
- Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors.European journal of endocrinology · 2022Article
- Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma.Cancers · 2021Article
- SPONTANEOUS CEREBROSPINAL FLUID LEAK AFTER INITIATION OF DOPAMINE AGONIST THERAPY IN MACROPROLACTINOMAS: TWO CASE REPORTS AND A LITERATURE REVIEW.AACE clinical case reportsArticle
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough several reports have addressed cerebrospinal fluid (CSF) rhinorrhea following dopamine agonist (DA) therapy of macroprolactinomas, further study is warranted for this relatively uncommon entity. Toward this aim, our retrospective series and review of literature further clarifies recommendations in treatment of this rare problem.
methodsWe retrospectively reviewed all macroprolactinoma cases in our hospital for a 15-year period. Our systematic search of PubMed identified original articles and reviews of all macroprolactinoma cases with an associated medication-induced CSF leak.
resultsFive patients with drug-induced CSF leak were identified; four of these patients received cabergoline therapy an average of 6 weeks before the onset of rhinorrhea and then underwent surgical repair of the CSF leak. Of 35 published studies included, we identified 60 patients with medication-induced CSF leak. Medical therapy included bromocriptine in 34 patients, cabergoline in 21 patients, and use of both DAs in two patients. Three cases did include complete diagnostic and treatment data. Median time from initiation of the DA treatment to occurrence of rhinorrhea was 6 weeks. For CSF rhinorrhea, 49 patients underwent surgical repair (38 by the transnasal approach) and seven patients were treated nonoperatively.
conclusionBaseline skull base erosion in macroprolactinomas in combination with subsequent tumor shrinkage induced by DA therapy may result in spontaneous CSF rhinorrhea. Therefore, such patients should be advised about and monitored for this potential setback. Once CSF leak is diagnosed, prompt treatment must be carried out to avoid infectious complications. Transnasal surgery appears the most effective therapeutic approach.
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