Prolactinoma during pregnancy causing compression symptoms responding to bromocriptine therapy

Area of Science:

• Endocrinology
• Neuro-ophthalmology
• Obstetrics

Background:

• Pituitary macroadenomas can cause significant mass effect during pregnancy.
• Hormonal changes in pregnancy can exacerbate pituitary tumor growth and associated symptoms.
• Cranial nerve palsies, particularly involving the third cranial nerve, are a rare but serious complication.

Observation:

• A pregnant patient presented with symptoms attributed to a pituitary macroadenoma.
• The patient exhibited a partial right third cranial nerve palsy, indicating neurological compromise.
• Pressure symptoms were directly linked to the pituitary macroadenoma's mass effect.

Findings:

• Complete resolution of the pituitary macroadenoma's pressure symptoms and third nerve palsy was achieved.
• Oral bromocriptine monotherapy was sufficient for successful treatment.
• The patient completed a full-term pregnancy without further complications.

Implications:

• Bromocriptine is a safe and effective treatment option for pituitary macroadenomas causing mass effect during pregnancy.
• Conservative management with bromocriptine can avoid more invasive procedures.
• This case highlights the importance of monitoring and prompt treatment of pituitary adenomas in pregnant patients.