A Case of Giant Prolactinoma Presented as a Nasopharyngeal Mass

ABSTRACT

Giant prolactinomas may present with atypical tumor mass effects, as they are characterized by massive extrasellar invasion. Nasopharyngeal involvement of prolactinoma is a rare condition and it has been described in some case reports in the literature. Medical management of prolactinomas with dopamine agonist drugs has been widely recommended as the first choice of treatment as it is very effective in decreasing  both tumor size and prolactin levels. Some acute complications, such as brain and optic chiasmal herniations, pneumocephalus and cerebrospinal fluid leakage during Cabergoline treatment have been reported. In order to avoid these life-threatening complications, Cabergolin dose should be titrated gradually and the patient should be evaluated closely, also with imaging studies in case of necessity. Here, we report a 19-year-of male patient with giant prolactinoma who presented with nasal obstructive symptoms and was diagnosed by nasopharyngeal biopsy. He was treated with Cabergoline successfully without any complication.