Faculty, Staff and Student Publications
Language
English
Publication Date
2-1-2026
Journal
JCEM Case Reports
DOI
10.1210/jcemcr/luaf318
PMID
41613299
PMCID
PMC12849361
PubMedCentral® Posted Date
1-28-2026
PubMedCentral® Full Text Version
Post-print
Abstract
We report a man in the fifth decade of his life with an invasive giant prolactinoma (size: 7.3 cm; serum prolactin 56820 ng/mL [SI: 2470.4 nmol/L], reference range, 5-25 ng/mL [SI: 0.22-1.09 nmol/L]) who presented with hypogonadism and headache. Dopamine agonist (DA) cabergoline (0.25 mg twice weekly) was initiated, and serum prolactin levels reached 3941 ng/mL (SI: 171.3 nmol/L) after 2 doses. Two weeks later, he developed acute symptoms of headache, vomiting, and drowsiness associated with cerebrospinal fluid rhinorrhea. He presented to the casualty after 48 hours of the onset of these acute symptoms in an altered state. Neuroimaging demonstrated extensive pneumocephalus with pneumoventricle. Cabergoline was discontinued, and an emergency neurosurgical repair was planned. Meanwhile, the patient's sensorium deteriorated, and he succumbed. Our case and review of 7 published cases of DA-induced pneumocephalus highlights male predominance, median tumor size of 5.5 cm (range, 4-9.5 cm), and onset within 1 to 12 weeks of initiation of DA therapy. Hence, for giant prolactinomas after DA initiation, it is essential to recognize the symptom complex associated with this rare life-threatening complication, pneumocephalus, and offer emergency surgical intervention.
Keywords
giant prolactinoma, dopamine agonist, cabergoline, pneumocephalus, CSF leak
Published Open-Access
yes
Recommended Citation
M H, Archana; Lila, Anurag Ranjan; Karlekar, Manjiri; et al., "Dopamine Agonist Therapy Induced Fatal Pneumocephalus in Giant Prolactinoma" (2026). Faculty, Staff and Student Publications. 4422.
https://digitalcommons.library.tmc.edu/uthmed_docs/4422