Cerebrospinal fluid rhinorrhea during treatment with bromocriptine for prolactinoma.
A 47-year-old man exhibited loss of libido and impotence in association with plasma hyperprolactinemia and a pituitary mass with downward extension of the tumor to the sphenoid sinus and to the suprasellar cisterns. Bromocriptine, 15 mg daily, reduced the hyperprolactinemia as well as tumor size. After 8 months on this therapy, the patient developed overt CSF liquorrhea. Five days after discontinuation of bromocriptine, the CSF rhinorrhea stopped, and when bromocriptine was given again 2 weeks later, CSF rhinorrhea returned within 3 days. We believe this phenomenon to be due to retraction of tumor by bromocriptine exposing a defect in the sella floor. Transient occurrence of CSF rhinorrhea can be considered as a consequence of tumor regression in patients on bromocriptine. The possibility of this complication, especially in patients with downward extension of tumor, should be noted.
D001971:Bromocriptine / Q000627:therapeutic use*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D006801:Humans; D007016:Hypophysectomy; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D011388:Prolactin / Q000378:metabolism*; D012658:Sella Turcica / Q000002:abnormalities; D014057:Tomography, X-Ray Computed
D001971:Bromocriptine; D011388:Prolactin