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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Conservative medical therapy for a macroprolactinoma presenting with obstructive hydrocephalus
Patricia Maria Gregoria Mina Cuaño1, Iris Thiele Isip-Tan2, Kevin Ivan Peñaverde Chan3
1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines pmgvmina@gmail.com.
BMJ Case Reports
|January 31, 2025
Summary
A rare case of obstructive hydrocephalus caused by a pituitary prolactinoma in a young woman was successfully treated with cabergoline. Medical management rapidly resolved symptoms and imaging findings, showing its potential utility.
Area of Science:
- Endocrinology
- Neurology
- Oncology
Background:
- Obstructive hydrocephalus is a rare complication of pituitary prolactinomas.
- Symptoms like amenorrhea in women often lead to early diagnosis, making this complication unusual.
Purpose of the Study:
- To present a case of obstructive hydrocephalus secondary to a macroprolactinoma in a young woman.
- To review the literature and assess the utility of medical management for this condition.
Main Methods:
- A case study of a female patient in her 20s presenting with severe headache.
- Cranial imaging revealed a sellar-suprasellar mass with obstructive hydrocephalus.
- Treatment with cabergoline initiated for hyperprolactinemia.
Main Results:
- Rapid resolution of headache within 24 hours of cabergoline initiation.
- Significant reduction (96%) in prolactin levels within one month.
- Complete resolution of obstructive hydrocephalus on imaging within 4 weeks.
Conclusions:
- Medical management with cabergoline can be effective for obstructive hydrocephalus secondary to macroprolactinoma.
- This approach offers a potential alternative to surgical intervention in selected cases.
- The case highlights the importance of considering endocrine causes for neurological symptoms.
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