BROMOCRIPTINE-INDUCED CEREBROSPINAL-FLUID FISTULA IN PATIENTS WITH MACROPROLACTINOMAS - REPORT OF 3 CASES AND A REVIEW OF THE LITERATURE

Bromocriptine therapy for macroprolactinoma induced cerebrospinal flui d (CSF) rhinorrhea in three patients. The tumor had extended well beyo nd the sella turcica and caused bony erosion in all the cases. All thr ee patients responded to bromocriptine therapy rapidly. CSF fistula oc curred concomitantly with the reduction of tumor size and caused menin gitis in two of the patients. Withdrawal of bromocriptine resulted in cessation of the leakage. One of the patients underwent transsphenoida l repair. Two patients refused surgery. This potentially lethal compli cation encountered in these three cases demonstrates the need for clos e supervision of macroprolactinoma patients with skull base erosion pl aced under bromocriptine therapy.