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Cavernous sinus syndrome due to prolactinoma: resolution with bromocriptine
Surgical Neurology
|March 1, 1983
Summary
Cavernous sinus syndrome from a prolactinoma is rare. Bromocriptine effectively treated a large prolactinoma, resolving visual defects and cranial nerve issues.
Area of Science:
- Neuro-oncology
- Endocrinology
Background:
- Cavernous sinus syndrome (CSS) is uncommon with pituitary tumors.
- Large prolactinomas can extend into the cavernous sinus, causing significant neurological deficits.
Observation:
- A patient presented with CSS, including bitemporal visual field defects, trigeminal nerve (fifth cranial nerve) dysfunction, and abducens nerve (sixth cranial nerve) palsy.
- The prolactinoma was large, with elevated prolactin levels (800-1000 ng/mL).
Findings:
- Treatment with daily bromocriptine (7.5 mg) led to significant tumor shrinkage.
- The patient experienced complete resolution of visual field defects and cranial nerve palsies within 6 months.
Implications:
- Bromocriptine is a viable initial therapy for prolactinomas with extrasellar extension.
- Early medical management can prevent or reverse severe neurological complications of pituitary tumors.