27May 2018

PNEUMATOCYST COMPLICATING A GIANT NECROTIC MACROPROLACTINOMA: ABOUT A VERY RARE CASE.

  • Department of Endocrinology, Diabetes, Metabolic diseases and Nutrition, Mohammed VI university hospital, Marrakech, Morocco.
  • Department of radiology, Mohammed VI university hospital, Cadi Ayad University, Marrakech, Morocco.
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Treatment of patients with giant and invasive macroprolactinomas consists of dopamine agonists (cabergoline or bromocriptine). When they reduce the size of invasive prolactinomas, the intra and extra cranial spaces may communicate causing cerebrospinal fluid (CSF) leakage and / or pneumocephalus which are very scarce complications after medical treatment. We report the case of an 18-year-old girl who was admitted in our department for hormonal evaluation of a pituitary tumor, she had been treated with cabergoline after a giant invasive prolactinoma was diagnosed. After 4 weeks, she presented with severe headaches and liquid nasal discharge, her brain CT showed a skull base lysis with erosion of the sellar floor creating a communication with the sphenoidal sinus resulting in a pneumatocyst. A depletive lumbar puncture was performed, with diamox and prophylactic antibiotics with a good evolution marked by the drying up of the CSF rhinorrhea. Clinicians should be aware of these complications symptoms to ensure proper diagnosis and treatment.

  1. Singh P et al. (2011) Bromocriptine or cabergoline-induced cerebrospinal fluid rhinorrhea: A life-threatening complication during management of prolactinoma. J Hum Reprod Sci. 4(2): 104?105.
  2. Bonneville JF et al. (2016) MRI of the Pituitary Gland. 65-70.
  3. Maiter D and Delgrange E. (2014) Therapy of endocrine disease: the challenges in managing?giant?prolactinomas. European Journal of Endocrinology. 170(6):R213-27
  4. Delgrange E et al. (1997) Sex-related difference in the growth of prolactinomas: a clinical and proliferation marker study. J Clin Endocrinol Metab. 82:2102?2107.
  5. Hubbard JL et al. (1985) Spontaneous cerebrospinal fluid rhinorrhea: evolving concepts in diagnosis and surgical management based on the Mayo Clinic experience from through. Neurosurgery. 16:314?321.
  6. Lam G et al. (2012) Spontaneous and medically induced cerebrospinal fluid leakage in the setting of pituitary adenomas: review of the literature. Neurosurg Focus. 32(6):E2
  7. Bronstein MD et al. (1989) Cerebrospinal fluid rhinorrhea occurring in long-term bromocriptine treatment for macroprolactinomas. Surg Neurol. 32(5):346-9.
  8. Prague JK et al. (2014) Delayed presentation of late-onset cerebrospinal fluid rhinorrhoea following dopamine agonist therapy for giant prolactinoma. Endocrinol Diabetes Metab Case Rep.2014:140020
  9. Padmanabhuni A et al. (2017) CSF rhinorrhea: an early complication of dopamine sensitive macroprolactinoma. AACE Clinical Case Reports: Vol. 3, No. 4, pp. e294-e298.
  10. Greenberg MS. (2006) 6th ed. New York: Thieme Medical Publishers. Handbook of neurosurgery: Pituitary adenomas; pp. 438?56.
  11. Thomas L. (1866) Du pneumatocele du crane. Arch Gen Med. 1:34?55.
  12. Markham JW. (1967) The clinical features of pneumocephalus based upon a survey of 284 cases with report of 11 additional cases. Acta Neurochir. 16:1?78.
  13. Elabd SS et al. (2018) Cabergoline-Induced Pneumocephalus Following Treatment for Giant Invasive Macroprolactinoma Presenting With Spontaneous Cerebrospinal Fluid Rhinorrhea. Clin Med Insights Endocrinol Diabetes. 11:1-6.
  14. Machicado JD et al. (2012) Cabergoline-Induced Pneumocephalus in a Medically Treated Macroprolactinoma. J Clin Endocrinol Metab, 97(10):3412?3413
  15. Jouret F and Col V. (2009) pneumocephalus during cabergoline treatment of an invasive macroprolactinoma. Acta Clin Belg. 64(5):457
  16. Nanba K et al. (2013). Tension pneumocephalus after administration of two 0.25 mg cabergoline tablets in MEN1-related Macroprolactinoma. BMJ Case Rep.
  17. DelGaudio JM and Ingley AP. (2010) Treatment of pneumocephalus after endoscopic sinus and microscopic skull base surgery. Am J Otolaryngol. 31:226?230.
  18. Lunsford LD et al. (1979) Subdural tension pneumocephalus. Report of two cases. J Neurosurg. 50:525?527.

[Zaher fatima zahra, elmghari ghizlane, rafi sana, cherif idrissi elganouni najat and el ansari nawal. (2018); PNEUMATOCYST COMPLICATING A GIANT NECROTIC MACROPROLACTINOMA: ABOUT A VERY RARE CASE. Int. J. of Adv. Res. 6 (May). 1096-1099] (ISSN 2320-5407). www.journalijar.com

ZAHER Fatima Zahra
Department of Endocrinology, Diabetes, Metabolic diseases and Nutrition, Mohammed VI university hospital, Marrakech, Morocco

DOI:

Article DOI: 10.21474/IJAR01/7133      
DOI URL: http://dx.doi.org/10.21474/IJAR01/7133

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