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Medically induced CSF rhinorrhea following treatment of macroprolactinoma: case series and literature review

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Abstract

Purpose

Although several reports have addressed cerebrospinal fluid (CSF) rhinorrhea following dopamine agonist (DA) therapy of macroprolactinomas, further study is warranted for this relatively uncommon entity. Toward this aim, our retrospective series and review of literature further clarifies recommendations in treatment of this rare problem.

Methods

We retrospectively reviewed all macroprolactinoma cases in our hospital for a 15-year period. Our systematic search of PubMed identified original articles and reviews of all macroprolactinoma cases with an associated medication-induced CSF leak.

Results

Five patients with drug-induced CSF leak were identified; four of these patients received cabergoline therapy an average of 6 weeks before the onset of rhinorrhea and then underwent surgical repair of the CSF leak. Of 35 published studies included, we identified 60 patients with medication-induced CSF leak. Medical therapy included bromocriptine in 34 patients, cabergoline in 21 patients, and use of both DAs in two patients. Three cases did include complete diagnostic and treatment data. Median time from initiation of the DA treatment to occurrence of rhinorrhea was 6 weeks. For CSF rhinorrhea, 49 patients underwent surgical repair (38 by the transnasal approach) and seven patients were treated nonoperatively.

Conclusion

Baseline skull base erosion in macroprolactinomas in combination with subsequent tumor shrinkage induced by DA therapy may result in spontaneous CSF rhinorrhea. Therefore, such patients should be advised about and monitored for this potential setback. Once CSF leak is diagnosed, prompt treatment must be carried out to avoid infectious complications. Transnasal surgery appears the most effective therapeutic approach.

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References

  1. Wong A, Eloy JA, Couldwell WT, Liu JK (2015) Update on prolactinomas. Part 1: clinical manifestations and diagnostic challenges. J Clin Neurosci 22(10):1562–1567

    PubMed  Google Scholar 

  2. Schlechte JA (2003) Clinical practice. Prolactinoma. N Engl J Med 349(21):2035–2041

    CAS  PubMed  Google Scholar 

  3. Mindermann T, Wilson CB (1994) Age-related and gender-related occurrence of pituitary adenomas. Clin Endocrinol (Oxf) 41(3):359–364

    CAS  Google Scholar 

  4. Beckers A, Daly AF (2007) The clinical, pathological, and genetic features of familial isolated pituitary adenomas. Eur J Endocrinol 157(4):371–382

    CAS  PubMed  Google Scholar 

  5. Maiter D, Delgrange E (2014) Therapy of endocrine disease: the challenges in managing giant prolactinomas. Eur J Endocrinol 170(6):213–227

    Google Scholar 

  6. Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montor VM, Schlechte JA, Wass JA (2011) Endocrine Society. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(2):273–288

    CAS  PubMed  Google Scholar 

  7. Colao A, Di Sarno A, Landi ML, Cirillo S, Sarnacchiaro F, Facciolli G, Pivonello R, Cataldi M, Merola B, Annunziato L, Lombardi G (1997) Long-term and low-dose treatment with cabergoline induces macroprolactinoma shrinkage. J Clin Endocrinol Metab 82(11):3574–3579

    CAS  PubMed  Google Scholar 

  8. Corsell SM, Ubertini G, Altomare M, Lovicu RM, Migneco MG, Rota CA, Colosimo C (2003) Giant prolactinomas in men: efficacy of cabergoline treatment. Clin Endocrinol 58(5):662–670

    Google Scholar 

  9. Landolt AM (1982) Cerebrospinal fluid rhinorrhea: a complication of therapy for invasive prolactimomas. Neurosurgery 11(3):395–401

    CAS  PubMed  Google Scholar 

  10. Barlas O, Bayindir C, Hepgül K, Can M, Kiriş T, Sencer E, Unal F, Aral F (1994) Bromocriptine-induced cerebrospinal fluid fistula in patients with macroprolactinomas: report of three cases and a review of the literature. Surg Neurol 41(6):486–489

    CAS  PubMed  Google Scholar 

  11. Cappabianca P, Lodrini S, Felisati G, Peca C, Cozzi R, Di Sarno A, Cavallo LM, Giombini S, Colao A (2001) Cabergoline-induced CSF rhinorrhea in patients with macroprolactinoma. Report of three cases. J Endocrinol Invest 24(3):183–187

    CAS  PubMed  Google Scholar 

  12. Netea-Maier RT, van Lindert EJ, Timmers H, Schakenraad EL, Grotenhuis JA, Hermus AR (2006) Cerebrospinal fluid leakage as complication of treatment with cabergoline for macroprolactinomas. J Endocrinol Invest 29(11):1001–1005

    CAS  PubMed  Google Scholar 

  13. Suliman SG, Gurlek A, Byrne JV, Sullivan N, Thanabalasingham G, Cudlip S, Ansorge O, Wass JA (2007) Nonsurgical cerebrospinal fluid rhinorrhea in invasive macroprolactinoma: incidence, radiological, and clinicopathological features. J Clin Endocrinol Metab 92(10):3829–3835

    CAS  PubMed  Google Scholar 

  14. De Lacy P, Benjamin S, Dixon R, Stephens JW, Redfern R, Price DE (2009) Is surgical intervention frequently required for medically managed macroprolactinomas? A study of spontaneous cerebrospinal fluid rhinorrhea. Surg Neurol 72(5):461–463

    PubMed  Google Scholar 

  15. Machicado JD, Varghese JM, Orlander PR (2012) Cabergoline-induced pneumocephalus in a medically treated macroprolactinoma. J Clin Endocrinol Metab 97(10):3412–3413

    CAS  PubMed  Google Scholar 

  16. Mankahla N, Peya B, Semple P, Ross I (2017) A giant invasive prolactinoma complicated by a cerebrospinal fluid leak: a short case report. Interdiscip Neurosurg 9(2):45–47

    Google Scholar 

  17. Acharya SV, Gopal RA, Menon PS, Bandgar TR, Shan NS (2010) Giant prolactinoma and effectiveness of medical management. Endocr Pract 16(1):42–46

    PubMed  Google Scholar 

  18. Afshar F, Thomas A (1982) Bromocriptine-induced cerebrospinal fluid rhinorrhea. Surg Neurol 18(1):61–63

    CAS  PubMed  Google Scholar 

  19. Baskin DS, Wilson CB (1982) CSF rhinorrhea after bromocriptine for prolactinoma. N Engl J Med 306(3):178

    CAS  PubMed  Google Scholar 

  20. Beckers A, Petrossians P, Abs R, Flandroy P, Stadnik T, de Longueville M, Lancranjan I, Stevenaert A (1992) Treatment of macroprolactinomas with the long-acting and repeatable form of bromocriptine: a report of 29 cases. J Clin Endocrinol Metab 75(1):275–280

    CAS  PubMed  Google Scholar 

  21. Bronstein MD, Musolino NR, Benabou S, Marino R Jr (1989) Cerebrospinal fluid rhinorrhea occurring in long-term bromocriptine treatment for macroprolactinomas. Surg Neurol 32(5):346–349

    CAS  PubMed  Google Scholar 

  22. Castro-Castro J, Torre-Eiriz JA, Pinzón-Millán A, Pastor-Zapata A (2011) Cabergoline-induced tension pneumocephalus in a patient with giant invasive prolactinoma. Case report. Neurocirugía 22(6):558–561

    CAS  PubMed  Google Scholar 

  23. Chapin W, Yedinak CG, Delashaw JB Jr, Fleseriu M (2010) Cabergoline-induced cerebral spinal fluid leak in a patient with a large prolactinoma and MEN1. Endocrinologist 20(4):198–202

    Google Scholar 

  24. Chattopadhyay A, Bhansali A, Masoodi SR (2005) Long-term efficacy of bromocriptine in macroprolactinomas and giant prolactinomas in men. Pituitary 8(2):147–154

    CAS  PubMed  Google Scholar 

  25. Clayton RN, Webb J, Heath DA, Dunn PJ, Rolfe EB, Hockley AD (1985) Dramatic and rapid shrinkage of a massive prolactinoma with bromocriptine: a case report. Clin Endocrinol 22(5):573–581

    CAS  Google Scholar 

  26. Delgrange E, Raverot G, Bex M, Burman P, Decoudier B, Devuyst F, Feldt-Rasmussen U, Andersen M, Maiter D (2013) Giant prolactinomas in women. Eur J Endocrinol 170(1):31–38

    PubMed  Google Scholar 

  27. Elgamal EA, Jamjoom ZA, Rahma HA (2001) Bromocriptine-induced cerebrospinal fluid rhinorrhea following successful treatment of invasive prolactinoma. PAN ARAB J Neurosurg 5:40–45

    Google Scholar 

  28. Eljamel MS, Foy PM, Swift AC, MacFarlane IA (1992) Cerebrospinal fluid rhinorrhea occurring in long-term bromocriptine treatment for macroprolactinomas. Surg Neurol 38(4):321

    CAS  PubMed  Google Scholar 

  29. Hewage UC, Colman PG, Kaye A (2000) Cerebrospinal fluid (CSF) rhinorrhoea occurring 6 days after commencement of bromocriptine for invasive macroprolactinoma. Aust N Z J Med 30(3):399–400

    CAS  PubMed  Google Scholar 

  30. Hildebrandt G, Zierski J, Christophis P, Laun A, Schatz H, Lancranjan I, Klug N (1989) Rhinorrhea following dopamine agonist therapy of invasive macroprolactinoma. Acta Neurochir 96(3–4):107–113

    CAS  PubMed  Google Scholar 

  31. Holness RO, Shlossberg AH, Heffernan LP (1984) Cerebrospinal fluid rhinorrhea caused by bromocriptine therapy of prolactinoma. Neurology 34(1):111–113

    CAS  PubMed  Google Scholar 

  32. Jouret F, Col V (2009) Pneumocephalus during cabergoline treatment of an invasive macroprolactinoma. Acta Clin Belg 64(5):457

    CAS  PubMed  Google Scholar 

  33. Kok JG, Bartelink AK, Schulte BP, Smals A, Pieters G, Meyer E, Merx H (1985) Cerebrospinal fluid rhinorrhea during treatment with bromocriptine for prolactinoma. Neurology 35(8):1193–1195

    CAS  PubMed  Google Scholar 

  34. Leong KS, Foy M, Swift AC, Atkin SL, Hadden DR, MacFarlane IA (2000) CSF rhinorrhoea following treatment with dopamine agonists for massive invasive prolactinomas. Clin Endocrinol 52(1):43–49

    CAS  Google Scholar 

  35. Little AS (2013) Repair of cerebrospinal fluid fistula from an invasive skull base prolactinoma using a septal mucosal vascularized flap: technical case report. J Neurol Surg A Cent Eur Neurosurg 74(Suppl 1):e50–e53

    PubMed  Google Scholar 

  36. Nadesapillai S, Balcere I, Kaye AH, Tress BM, Colman PG (2004) Acute complications of dopamine agonist treatment for macroprolactinoma—how uncommon? J Clin Neurosci 11(8):825–828

    CAS  PubMed  Google Scholar 

  37. Nakajima T, Tamura T, Kuroki M, Tanaka R, Hayashi H (1992) A case of prolactinoma presenting with CSF rhinorrhea and CSF otorrhea during bromocriptine therapy. No Shinkei Geka 20(10):1091–1095

    CAS  PubMed  Google Scholar 

  38. Pascal-Vigneron V, Weryha G, Braun M, Morel-Jean J, Bisset S, Leclère J (1994) Rhinorrhea and otorrhea: rare complications of the medical treatment in invasive prolactinomas. Ann Endocrinol (Paris) 54(5):347–351

    CAS  Google Scholar 

  39. Russell NA, Al-Rajeh S, Al-Fayez N, Joaquin AJ, Bakhr AA (1994) Bromocriptine-induced cerebrospinal fluid rhinorrhea in invasive prolactinoma: case report and review of the literature. Ann Saudi Med 14(1):64–67

    CAS  PubMed  Google Scholar 

  40. Shrivastava RK, Arginteanu MS, King WA, Post KD (2002) Giant prolactinomas: clinical management and long-term follow up. J Neurosurg 97(2):299–306

    PubMed  Google Scholar 

  41. Siegel RD, Lee SL (1996) Pneumocephalus and cerebrospinal fluid rhinorrhea after bromocriptine therapy of an invasive prolactinoma: a case report and review of the literature. Endocrinologist 6:148–152

    Google Scholar 

  42. Wilson JD, Newcombe RL, Long FL (1983) Cerebrospinal fluid rhinorrhoea during treatment of pituitary tumours with bromocriptine. Acta Endocrinol (Copenh) 103(4):457–460

    CAS  Google Scholar 

  43. Moraes AB, Silva CM, Vieira Neto L, Gadelha MR (2013) Giant prolactinomas: the therapeutic approach. Clin Endocrinol (Oxf) 9(4):447–456

    Google Scholar 

  44. Raverot G, Wierinckx A, Dantony E, Auger C, Chapas G, Villeneuve L, Brue T, Figarella-Branger D, Roy P, Jouanneau E, Jan M, Lachuer J, Trouillas J (2010) Prognostic factors in prolactin pituitary tumors: clinical, histological, and molecular data from a series of 94 patients with a long postoperative follow-up. J Clin Endocrinol Metab 95(4):1708–1716

    CAS  PubMed  Google Scholar 

  45. Madsen H, Borges TM, Knox AJ, Michaelis KA, Xu M, Lillehei KO, Wierman ME, Kleinschmidt-DeMasters BK (2011) Giant pituitary adenomas: pathologic–radiographic correlations and lack of role for p53 and MIB-1 labeling. Am J Surg Pathol 35(8):1204–1213

    PubMed  Google Scholar 

  46. Wierinckx A, Roche M, Raverot G, Legras-Lachuer C, Croze S, Nazaret N, Rey C, Auger C, Jouanneau E, Chanson P, Trouillas J, Lachuer J (2011) Integrated genomic profiling identifies loss of chromosome 11p impacting transcriptomic activity in aggressive pituitary PRL tumors. Brain Pathol 21(5):533–543

    CAS  PubMed  Google Scholar 

  47. Chinezu L, Vasiljevic A, Jouanneau E, François P, Borda A, Trouillas J, Raverot G (2014) Expression of somatostatin receptors, SSTR2A and SSTR5, in 108 endocrine pituitary tumors using immunohistochemical detection with new specific monoclonal antibodies. Hum Pathol 45(1):71–77

    CAS  PubMed  Google Scholar 

  48. Alkabbani AG, Mon SY, Hatipoglu B, Kennedy L, Faiman C, Weil RJ, Hamrahian AH (2017) Is a stable or decreasing prolactin level in a patient with prolactinoma a surrogate marker for lack of tumor growth? Pituitary 17(2):97–102

    Google Scholar 

  49. Tirosh A, Shimon I (2015) Management of macroprolactinomas. Clin Diabetes Endocrinol 1:5

    PubMed  PubMed Central  Google Scholar 

  50. Knoepfelmacher M, Gomes MC, Melo ME, Mendonca BB (2004) Pituitary apoplexy during therapy with cabergoline in an adolescent male with prolactin-secreting macroadenoma. Pituitary 7(2):83–87

    PubMed  Google Scholar 

  51. Wong A, Eloy JA, Couldwell WT, Liu JK (2015) Update on prolactinomas. Part 2: treatment and management strategies. J Clin Neurosci 22(10):1568–1574

    PubMed  Google Scholar 

  52. Verhelst J, Abs R, Maiter D, van den Bruel A, Vandeweghe M, Velkeniers B, Mockel J, Lamberigts G, Petrossians P, Coremans P, Mahler C, Stevenaert A, Verlooy J, Raftopoulos C, Beckers A (1999) Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients. J Clin Endocrinol Metab 84(7):2518–2522

    CAS  PubMed  Google Scholar 

  53. Melmed S, Popovic V, Bidlingmaier M, Mercado M, van der Lely AJ, Biermasz N, Bolanowsk M, Coculescu M, Schopohl J, Racz K, Glaser B, Goth M, Greenman Y, Trainer P, Mezosi E, Shimon I, Giustina A, Korbonits M, Bronstein MD, Kleinberg D, Teichman S, Gliko-Kabir I, Mamluk R, Haviv A, Strasburger C (2015) Safety and efficacy of oral octreotide in acromegaly: results of a multicenter phase III trial. J Clin Endocrinol Metab 100(4):1699–1708

    CAS  PubMed  Google Scholar 

  54. Molitch ME, Elton RL, Blackwell RE, Caldwell B, Chang RJ, Jaffe R, Joplin G, Robbins RJ, Tyson J, Thorner MO (1985) Bromocriptine as primary therapy for prolactin-secreting macroadenomas: results of a prospective multicenter study. J Clin Endocrinol Metab 60(4):698–705

    CAS  PubMed  Google Scholar 

  55. Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF (1994) A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med 331(14):904–909

    CAS  PubMed  Google Scholar 

  56. Mancini T, Casanueva FF, Giustina A (2008) Hyperprolactinemia and prolactinomas. Endocrinol Metab Clin N Am 37(1):67–99

    CAS  Google Scholar 

  57. Ono M, Miki N, Kawamata T, Makino R, Amano K, Seki T, Kubo O, Hori T, Takano K (2008) Prospective study of high-dose cabergoline treatment of prolactinomas in 150 patients. J Clin Endocrinol Metab 93(12):4721–4727

    CAS  PubMed  Google Scholar 

  58. Molitch ME (2014) Management of medically refractory prolactinoma. J Neurooncol 117(3):421–428

    PubMed  Google Scholar 

  59. Di Sarno A, Landi ML, Marzullo P, Di Somma C, Pivonello R, Cerbone G, Lombardi G, Colao A (2000) The effect of quinagolide and cabergoline, two selective dopamine receptor type 2 agonists, in the treatment of prolactinomas. Clin Endocrinol (Oxf) 53(1):53–60

    Google Scholar 

  60. Murphy FY, Vesely DL, Jordan RM, Flanigan S, Kohler PO (1987) Giant invasive prolactinomas. Am J Med 83(5):995–1002

    CAS  PubMed  Google Scholar 

  61. Davis JR, Sheppard MC, Heath DA (1990) Giant invasive prolactinoma: a case report and review of nine further cases. Q J Med 74(275):227–238

    CAS  PubMed  Google Scholar 

  62. Couldwell WT, Weiss MH, Laws ER Jr (2004) Prolactinomas. N Engl J Med 350(10):1054–1057

    CAS  PubMed  Google Scholar 

  63. Kreutzer J, Buslei R, Wallaschofski H, Hofmann B, Nimsky C, Fahlbusch R, Buchfelder M (2008) Operative treatment of prolactinomas: indications and results in a current consecutive series of 212 patients. Eur J Endocrinol 158(1):11–18

    CAS  PubMed  Google Scholar 

  64. Telera S, Conte A, Cristalli G, Occhipinti E, Pompili A (2007) Spontaneous cerebrospinal fluid rhinorrhea as the presenting symptom of sellar pathologies: three demonstrative cases. Neurosurg Rev 30(1):78–82

    PubMed  Google Scholar 

  65. Lam G, Mehta V, Zada G (2012) Spontaneous and medically induced cerebrospinal fluid leakage in the setting of pituitary adenomas: review of the literature. Neurosurg Focus 32(6):E2

    PubMed  Google Scholar 

  66. Ciric I, Ragin A, Baumgartner C, Pierce D (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40(2):225–236

    CAS  PubMed  Google Scholar 

  67. Aronoff SL, Daughaday WH, Laws ER Jr (1979) Bromocriptine treatment of prolactinomas. N Engl J Med 300(24):1391

    CAS  PubMed  Google Scholar 

  68. Aarabi B, Leibrock LG (1992) Neurosurgical approaches to cerebrospinal fluid rhinorrhea. Ear Nose Throat J 71(7):300–305

    CAS  PubMed  Google Scholar 

  69. Singh P, Singh M, Cugati G, Singh AK (2011) Bromocriptine or cabergoline-induced cerebrospinal fluid rhinorrhea: a life-threatening complication during management of prolactinoma. J Hum Reprod Sci 4(2):104–105

    PubMed  PubMed Central  Google Scholar 

  70. Zada G, Lin N, Laws ER Jr (2010) Patterns of extrasellar extension in growth hormone-secreting and nonfunctional pituitary macroadenomas. Neurosurg Focus. 29(4):E4

    PubMed  Google Scholar 

  71. Bevan JS, Webster J, Burke CW, Scanlon MF (1992) Dopamine agonists and pituitary tumor shrinkage. Endocr Rev 13(2):220–240

    CAS  PubMed  Google Scholar 

  72. Hanel RA, Prevedello DM, Correa A, Antoniuk A, Araújo JC (2001) Cerebrospinal fluid fistula as the presenting manifestation of pituitary adenoma. Arq Neuropsiquiatr 59(2-A):263–265

    CAS  PubMed  Google Scholar 

  73. Ommaya A (1996) Cerebral spinal fluid fistula and pneumocephalus. McGraw-Hill, New York

    Google Scholar 

  74. Schlosser RJ, Wilensky EM, Grady MS, Palmer JN, Kennedy DW, Bolger WE (2004) Cerebrospinal fluid pressure monitoring after repair of cerebrospinal fluid leaks. Otolaryngol Head Neck Surg 130(4):443–448

    PubMed  Google Scholar 

  75. Lobo BC, Baumanis MM, Nelson RF (2017) Surgical repair of spontaneous cerebrospinal fluid (CSF) leaks: a systematic review. Laryngoscope Investig Otolaryngol 2(5):215–224

    PubMed  PubMed Central  Google Scholar 

  76. Jones SE, James RA, Hall K, Kendall-Taylor P (2000) Optic chiasmal herniation: an under recognized complication of dopamine agonist therapy for macroprolactinoma. Clin Endocrinol (Oxf) 53(4):529–534

    CAS  Google Scholar 

  77. Sibal L, Ugwu P, Kendall-Taylor P, Ball SG, James RA, Pearce SH, Hall K, Quinton R (2002) Medical therapy of macroprolactinomas in males: I. Prevalence of hypopituitarism at diagnosis. II. Proportion of cases exhibiting recovery of pituitary function. Pituitary 5(4):243–246

    PubMed  Google Scholar 

  78. Raverot G, Jacob M, Jouanneau E, Delemer B, Vighetto A, Pugeat M, Borson-Chazot F (2009) Secondary deterioration of visual field during cabergoline treatment for macroprolactinoma. Clin Endocrinol (Oxf) 70(4):588–592

    CAS  Google Scholar 

  79. Leek RD, Talks KL, Pezzella F, Turley H, Campo L, Brown NS, Bicknell R, Taylor M, Gatter KC, Harris AL (2002) Relation of hypoxia-inducible factor-2α (HIF-2α) expression in tumor-infiltrative macrophages to tumor angiogenesis and the oxidative thymidine phosphorylase pathway in human breast cancer. Cancer Res 62(5):1326–1329

    CAS  PubMed  Google Scholar 

  80. Giraudo E, Inoue M, Hanahan D (2004) An amino-bisphosphonate targets MMP-9-expressing macrophages and angiogenesis to impair cervical carcinogenesis. J Clin Invest 114(5):623–633

    CAS  PubMed  PubMed Central  Google Scholar 

  81. Varney ML, Johansson SL, Singh RK (2005) Tumour-associated macrophage infiltration, neovascularization and aggressiveness in malignant melanoma: role of monocyte chemotactic protein-1 and vascular endothelial growth factor-A. Melanoma Res 15(5):417–425

    CAS  PubMed  Google Scholar 

  82. Condeelis J, Pollard JW (2006) Macrophages: obligate partners for tumor cell migration, invasion, and metastasis. Cell 124(2):263–266

    CAS  PubMed  Google Scholar 

  83. Turner HE, Nagy Z, Esiri MM, Harris AL, Wass JA (2000) Role of matrix metalloproteinase 9 in pituitary tumor behavior. J Clin Endocrinol Metab 85(8):2931–2935

    CAS  PubMed  Google Scholar 

  84. Vleminckx K, Vakaet L Jr, Mareel M, Fiers W, van Roy F (1991) Genetic manipulation of E-cadherin expression by epithelial tumor cells reveals an invasion suppressor role. Cell 66(1):107–119

    CAS  PubMed  Google Scholar 

  85. Qian ZR, Li CC, Yamasaki H, Mizusawa N, Yoshimoto K, Yamada S, Tashiro T, Horiguchi H, Wakatsuki S, Hirokawa M, Sano T (2002) Role of E-cadherin, α-, β-, and γ-catenins, and p120 (cell adhesion molecules) in prolactinoma behavior. Mod Pathol 15(12):1357–1365

    PubMed  Google Scholar 

  86. Even-Ram S, Uziely B, Cohen P, Grisaru-Granovsky S, Maoz M, Ginzburg Y, Reich R, Vlodavsky I, Bar-Shavit R (1998) Thrombin receptor overexpression in malignant and physiological invasion processes. Nat Med 4(8):909–914

    CAS  PubMed  Google Scholar 

  87. Darmoul D, Gratio V, Devaud H, Lehy T, Laburthe M (2003) Aberrant expression and activation of the thrombin receptor protease-activated receptor-1 induces cell proliferation and motility in human colon cancer cells. Am J Pathol 162(5):1503–1513

    CAS  PubMed  PubMed Central  Google Scholar 

  88. Boire A, Covic L, Agarwal A, Jacques S, Sherifi S, Kuliopulos A (2005) PAR1 is a matrix metalloprotease-1 receptor that promotes invasion and tumorigenesis of breast cancer cells. Cell 120(3):303–313

    CAS  PubMed  Google Scholar 

  89. Madsen H, Borges TM, Knox AJ, Michaelis KA, Xu M, Lillehei KO, Wierman ME, Kleinschmidt-DeMasters BK (2011) Giant pituitary adenomas: pathologic–radiographic correlations and lack of role for p53 and MIB-1 labeling. A J Surg Pathol 35(8):1204–1213

    Google Scholar 

  90. Song YJ, Chen MT, Lian W, Xing B, Yao Y, Feng M, Wang RZ (2017) Surgical treatment for male prolactinoma: a retrospective study of 184 cases. Medicine (Baltimore) 96(2):e5833

    Google Scholar 

  91. Shetty PG, Shroff MM, Fatterpekar GM, Sahani DV, Kirtane MV (2000) A retrospective analysis of spontaneous sphenoid sinus fistula MR and CT findings. AJNR 21(2):337–342

    CAS  PubMed  Google Scholar 

  92. Meco C, Oberascher G (2004) Comprehensive algorithm for skull base dural lesion and cerebrospinal fluid fistula diagnosis. Laryngoscope 114(6):991–999

    PubMed  Google Scholar 

  93. Oakley GM, Alt JA, Schlosser RJ, Harvey RJ, Orlandi RR (2016) Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations. Int Forum Allergy Rhinol 6(1):8–16

    PubMed  Google Scholar 

  94. Cappabianca P, Alfieri A, de Divitiis E (1998) Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS). Minim Invasive Neurosurg 41(2):66–73

    CAS  PubMed  Google Scholar 

  95. Hirsch O (1952) Successful closure of cerebrospinal fluid rhinorrhea by endonasal surgery. AMA Arch Otolaryngol 56(1):1–12

    CAS  PubMed  Google Scholar 

  96. Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, Mintz A (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116(10):1882–1886

    PubMed  Google Scholar 

  97. Eloy JA, Kuperan AB, Choudhry OJ, Harirchian S, Liu JK (2012) Efficacy of the pedicled nasoseptal flap without cerebrospinal fluid (CSF) diversion for repair of skull base defects: incidence of postoperative CSF leaks. Int Forum Allergy Rhinol 2(5):397–401

    PubMed  Google Scholar 

  98. Liu JK, Schmidt RF, Choudhry OJ, Shukla PA, Eloy JA (2012) Surgical nuances for nasoseptal flap reconstruction of cranial base defects with high-flow cerebrospinal fluid leaks after endoscopic skull base surgery. Neurosurg Focus 32(6):E7

    PubMed  Google Scholar 

  99. Adams AS, Russell PT, Duncavage JA, Chandra RK, Turner JH (2016) Outcomes of endoscopic repair of cerebrospinal fluid rhinorrhea without lumbar drains. Am J Rhinol Allergy 30(6):424–429

    PubMed  Google Scholar 

  100. Stokken J, Recinos PF, Woodard T, Sindwani R (2015) The utility of lumbar drains in modern endoscopic skull base surgery. Curr Opin Otolaryngol Head Neck Surg 23(1):78–82

    PubMed  Google Scholar 

  101. Lindstrom DR, Toohill RJ, Loehrl TA, Smith TL (2004) Management of cerebrospinal fluid rhinorrhea: the medical college of Wisconsin experience. Laryngoscope 114(6):969–974

    PubMed  Google Scholar 

  102. Carrau RL, Snyderman CH, Kassam AB (2005) The management of cerebrospinal fluid leaks in patients at risk for high-pressure hydrocephalus. Laryngoscope 115(2):205–212

    PubMed  Google Scholar 

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Acknowledgements

We thank Jan Kremláček for helpful comments and Peter Poczos for help with graphical editing.

Funding

The authors have received no funding.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

    Tomáš Česák, Pavel Poczos, Jaroslav Adamkov & Jiří Náhlovský

  2. Department of Anatomy, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

    Pavel Poczos

  3. The Fingerland Department of Pathology, University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

    Petra Kašparová

  4. 4th Department of Internal Medicine – Haematology, University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

    Filip Gabalec

  5. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

    Petr Čelakovský

  6. Saint Alphonsus Neuroscience Institute - Neurosurgery, Boise, ID, USA

    Ondrej Choutka

Authors
  1. Tomáš Česák
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  2. Pavel Poczos
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  3. Jaroslav Adamkov
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  4. Jiří Náhlovský
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  5. Petra Kašparová
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  6. Filip Gabalec
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  7. Petr Čelakovský
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  8. Ondrej Choutka
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Corresponding author

Correspondence to Pavel Poczos.

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Česák, T., Poczos, P., Adamkov, J. et al. Medically induced CSF rhinorrhea following treatment of macroprolactinoma: case series and literature review. Pituitary 21, 561–570 (2018). https://doi.org/10.1007/s11102-018-0907-1

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  • DOI: https://doi.org/10.1007/s11102-018-0907-1

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