Cerebrospinal fluid rhinorrhea caused by bromocriptine therapy of prolactinoma

We studied a man with cerebrospinal fluid rhinorrhea due to bromocriptine-induced shrinkage of a prolactin-secreting pituitary tumor. Unlike other reported cases with pituitary tumors and rhinorrhea, our patient never had previous radiotherapy or surgery. The fistula was clearly demonstrated by CT. The original signs included homonymous hemianopia due to a left optic tract compression. Bromocriptine treatment is an invaluable adjunct in long-term management of invasive prolactinomas, but surgical intervention is indicated if a CSF fistula results.