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Microprolactinoma with visual field defect: An unsuspected etiology.

K V S Hari Kumar1, Shikar Gaur, Somasekharan Manoj

  • 1Department of Endocrinology, Command Hospital, Central Command, Lucknow, Uttar Pradesh, India.

Indian Journal of Endocrinology and Metabolism
|November 20, 2013
PubMed
Summary

Microprolactinomas rarely cause visual field defects. This case highlights a rare association with idiopathic intracranial hypertension (IIH) in a microprolactinoma patient, successfully treated with medication.

Keywords:
Diopathic intracranial hypertensionmicroprolactinomavisual field defect

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Area of Science:

  • Neuroendocrinology
  • Ophthalmology
  • Neurology

Background:

  • Microprolactinomas, small pituitary tumors secreting prolactin, typically present with menstrual irregularities and galactorrhea.
  • Visual field defects are uncommon in microprolactinomas as they are confined within the sella turcica.

Observation:

  • A young female patient presented with a microprolactinoma and concurrent visual field defects, posing a diagnostic challenge.
  • The unusual presentation prompted an extensive etiological investigation to identify the cause of visual impairment.

Findings:

  • The work-up revealed a co-existing diagnosis of idiopathic intracranial hypertension (IIH) in the patient with microprolactinoma.
  • Combined treatment with Acetazolamide for IIH and Cabergoline for the microprolactinoma led to complete resolution of symptoms and visual defects.

Implications:

  • This case underscores the importance of considering alternative diagnoses, such as IIH, when visual field defects occur in patients with microprolactinoma.
  • The successful management highlights a potential therapeutic approach for this rare clinical presentation.
  • It expands the understanding of potential comorbidities and diagnostic considerations in patients with pituitary microadenomas.