Treatment Strategy for Giant Invasive Macroprolactinoma with Spontaneous Cerebrospinal Fluid Rhinorrhea: A Case Report and Literature Review

Abe, Daishiro; Ogiwara, Toshihiro; Nakamura, Takuya; Ichinose, Shunsuke; Fujii, Yu; Hanaoka, Yoshiki; Itō, Kiyoshi; Horiuchi, Tetsuyoshi

doi:10.1016/j.wneu.2020.08.129

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Leuprolide or any drug that can potentially increase intracranial pressure should be held for 3 months after surgery or until after a skull base defect has fully healed. Considering bromocriptine resulting in spontaneous CSF rhinorrhea, especially in macroprolactinomas, patients taking bromocriptine before the operation should be vigilant for postoperative CSF leakage ( 32 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors of cerebrospinal fluid leakage after neuroendoscopic transsphenoidal pituitary adenoma resection: a systematic review and meta-analysis

Zhao,

Wang,

Zhao

et al. 2024

Front. Endocrinol.

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IntroductionCerebro spinal fluid (CSF) leakage is common and might lead to severe postoperative complications after endoscopic transsphenoidal pituitary adenoma resection. However, the risk factors of postoperative CSF leakage are still controversial. This article presents a systematic review to explore the explicit risk factors of CSF leakage after endoscopic transsphenoidal pituitary adenomere section.MethodsPRISMA and AMSTAR guidelines were followed to assess the methodological quality of the systematic review. PubMed, Medline, Embase, Web of Science, Cochrane, Clinical Trails, CNKI, CBM, Wan Fang, and VIP databases were searched for all studies on postoperative CSF leak risk factors. The quality of the included studies was assessed by the Newcastle-Ottawa scale. Review Manager 5.4 software was used to calculate the pooled effect size of potential factors with statistical significance.ResultsA total of 6775 patients with pituitary adenoma across 18 articles were included, containing 482 cases of postoperative CSF leakage (accounting for 7.11%). All of the articles had a quality score > 5, indicating good quality. Meta-analysis showed that an increased risk of CSF leak was found for higher levels of BMI (MD=1.91, 95% CI (0.86,2.96), bigger tumor size [OR=4.93, 95% CI (1.41,17.26)], greater tumor invasion (OR=3.01, 95% CI (1.71, 5.31), the harder texture of tumor [OR=2.65, 95% CI (1.95,3.62)], intraoperative cerebrospinal fluid leakage [OR=5.61, 95% CI (3.53,8.90)], multiple operations [OR=2.27, 95% CI (1.60,3.23)].ConclusionBMI, multiple operations, tumor size, tumor invasion, hard texture, and intraoperative cerebrospinal fluid leakage are the risk factors of postoperative CSF leakage. Clinical doctors should pay attention to these risk factors, and conduct strict skull base reconstruction and careful postoperative management.

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Section: Discussionmentioning

confidence: 99%

Risk factors of cerebrospinal fluid leakage after neuroendoscopic transsphenoidal pituitary adenoma resection: a systematic review and meta-analysis

Zhao,

Wang,

Zhao

et al. 2024

Front. Endocrinol.

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“…В 2020 г. D. Abe и соавт. [34] опубликовали сообщение о случае СНЛ, вызванной гигантской пролактиномой (рис. 3).…”

Section: обзор литературы | Literature Reviewunclassified

Spontaneous cerebrospinal fluid rhinorrhea: literature review

Antipov,

Kalandari

2024

Nejrohirurgiâ (Mosk.)

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Due to its rarity and complex etiopathogenesis, spontaneous cerebrospinal fluid rhinorrhea remains an understudied problem. Similarity of symptoms with other disorders of the ENT organs, low vigilance of primary care specialists lead to delayed diagnosis and treatment increasing the risk of complications. In recent years, diagnosis and treatment of this pathology have received a higher level of attention as evidenced by increased number of publications on this topic.The review considers in detail the problems of etiopathogenesis, classification, diagnosis and treatment of spontaneous cerebrospinal fluid rhinorrhea based on current data from scientific literature.

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Bromocriptine/cabergoline

2020

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Treatment Strategy for Giant Invasive Macroprolactinoma with Spontaneous Cerebrospinal Fluid Rhinorrhea: A Case Report and Literature Review

Cited by 5 publications

References 16 publications

Risk factors of cerebrospinal fluid leakage after neuroendoscopic transsphenoidal pituitary adenoma resection: a systematic review and meta-analysis

Risk factors of cerebrospinal fluid leakage after neuroendoscopic transsphenoidal pituitary adenoma resection: a systematic review and meta-analysis

Spontaneous cerebrospinal fluid rhinorrhea: literature review

Bromocriptine/cabergoline

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