Insights in Neurosurgery

Epistaxis as first clinical presentation in prolactinoma

It may be particularly giant and invasive. It has wide way of presentation. Epistaxis due to prolactinoma has been rarely reported in the literature. Material and methods: We report the case of a 48 year old man presented with epistaxis and headache since two months, who was admitted for an acute worsening of his headache and epistaxis without visual troubles. Otherwise he had erectile dysfunction for 2 years. Results: The patient was fully conscious and didn’t present any localization sign. The examination of the cranial nerves was normal. He had gynecomastia and morbid obesity. Brain MRI revealed a pituitary macroadenoma which eroded the sella turcica with stigmata of recent bleeding. Hormonal tests concluded to a prolactinoma. The patient received cabergoline with favorable clinical course. Discussion and conclusion: Pituitary adenoma presents with headache, visual deterioration and various kinds of endocrinopathies. Rarely pituitary adenoma especially prolactinoma can present with epistaxis. The first line treatment is based on dopamine agonist who can lead to a reduction of the tumor volume and disappearance of epistaxis from the infected area.

Author(s):

Kaouther Somrani

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