ArticleIndian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India2025
Invasive Pituitary Macroprolactinoma with Spontaneous CSF Rhinorrhea- A Case Report with a Review of the Literature and a Strategical Plan of Management.
Article in Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Cerebrospinal fluid (CSF) rhinorrhea is a rare and unexpected initial presentation of untreated invasive pituitary macroprolactinoma. This article aims to better understand the management of invasive pituitary macroprolactinoma, especially in cases where the patient initially presents with a CSF leak. We describe a case of a 36-year-old male with untreated invasive macroprolactinoma with a CSF leak at the initial presentation. The role and timing of medical and surgical treatment in such a setting are outlined in detail. Medical therapy has shown both worsening and resolution of the CSF leak. We propose a ''Sandwich Therapy'' in Dopamine agonist (DA) responsive cases where the leak persists, which includes initial DA therapy, followed by endoscopic Transsphenoidal surgery (TSS) with DA therapy and then followed by the post-operative continuation of DA therapy.
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