{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:40:09Z","timestamp":1756316409200,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,18]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Obstructive hydrocephalus is a rare complication of pituitary prolactinomas, especially in women, where symptoms of amenorrhoea rarely go unnoticed. In this study, a case of a female in her 20s with a 2-month history of frontotemporal headache, acutely worsening over 3\u2009days, is presented. Cranial imaging showed a sellar-suprasellar mass (2.6 \u00d7 3.5 \u00d7 3.6 cm) with associated obstructive hydrocephalus and tonsillar herniation. Hyperprolactinaemia was confirmed, and cabergoline was initiated. Clinically, the patient\u2019s headache resolved within 24 hours of the first dose, and repeat prolactin levels fell by 96% within the first month. Repeat imaging confirmed the resolution of the obstructive hydrocephalus within 4\u2009weeks. The patient was able to return to her work, and her menses resumed more than a year later. This case and the corresponding review of the literature demonstrate the possible utility of medical management in cases of obstructive hydrocephalus secondary to a macroprolactinoma.<\/jats:p>","DOI":"10.1136\/bcr-2024-261540","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T12:05:20Z","timestamp":1738325120000},"page":"e261540","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Conservative medical therapy for a macroprolactinoma presenting with obstructive hydrocephalus"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8392-3606","authenticated-orcid":false,"given":"Patricia Maria Gregoria Mina","family":"Cua\u00f1o","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3227-632X","authenticated-orcid":false,"given":"Iris Thiele","family":"Isip-Tan","sequence":"additional","affiliation":[{"name":"Medical Informatics Unit, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1341-5278","authenticated-orcid":false,"given":"Kevin Ivan Pe\u00f1averde","family":"Chan","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"2025082710080073000_18.1.e261540.1","unstructured":"Melmed S . Pituitary masses and tumors. In: Melmed S , Auchus RJ , Goldfine AB , et al , eds. Williams textbook of endocrinology. 14th edn. Philadelphia: Elsevier, 2020: 236\u2013302."},{"key":"2025082710080073000_18.1.e261540.2","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1038\/s41574-023-00886-5","article-title":"Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement","volume":"19","author":"Petersenn","year":"2023","journal-title":"Nat Rev Endocrinol"},{"key":"2025082710080073000_18.1.e261540.3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.15605\/jafes.026.01.17","article-title":"An Unusual Cystic Sellar-Suprasellar Mass in a Young Female","volume":"26","author":"Jaring","year":"2011","journal-title":"JAFES"},{"key":"2025082710080073000_18.1.e261540.4","first-page":"7","article-title":"Current treatment status of adult brain tumors in the Philippine general hospital","volume":"02","author":"Roxas","year":"2017","journal-title":"J Neurol Neurorehabil Res"},{"key":"2025082710080073000_18.1.e261540.5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/neuros\/nyw013","article-title":"Sellar and Parasellar Imaging","volume":"80","author":"Zamora","year":"2017","journal-title":"Neurosurgery"},{"key":"2025082710080073000_18.1.e261540.6","doi-asserted-by":"crossref","first-page":"e686","DOI":"10.1016\/j.wneu.2019.05.249","article-title":"Radiographic and Hormonal Regression in Prolactinomas: An Analysis of Treatment Failure","volume":"129","author":"Akinduro","year":"2019","journal-title":"World Neurosurg"},{"key":"2025082710080073000_18.1.e261540.7","doi-asserted-by":"crossref","first-page":"101290","DOI":"10.1016\/j.beem.2019.101290","article-title":"The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new","volume":"33","author":"Chanson","year":"2019","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2025082710080073000_18.1.e261540.8","doi-asserted-by":"crossref","DOI":"10.1210\/jendso\/bvab160","article-title":"Pediatric Giant Prolactinoma Presenting With Acute Obstructive Hydrocephalus and Intracranial Hypertension","volume":"5","author":"Hendrix","year":"2021","journal-title":"J Endocr Soc"},{"key":"2025082710080073000_18.1.e261540.9","doi-asserted-by":"publisher","DOI":"10.4065\/74.5.475"},{"key":"2025082710080073000_18.1.e261540.10","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-018-1890-x","article-title":"Giant prolactinoma, germline BRCA1 mutation, and depression: a case report","volume":"12","author":"Bettencourt-Silva","year":"2018","journal-title":"J Med Case Rep"},{"key":"2025082710080073000_18.1.e261540.11","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/00004728-198402000-00027","article-title":"Rapid size reduction of giant prolactinoma following medical treatment","volume":"8","author":"Perani","year":"1984","journal-title":"J Comput Assist Tomogr"},{"key":"2025082710080073000_18.1.e261540.12","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/30.5.426"},{"key":"2025082710080073000_18.1.e261540.13","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afh108"},{"key":"2025082710080073000_18.1.e261540.14","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-005-2319-0"},{"key":"2025082710080073000_18.1.e261540.15","doi-asserted-by":"crossref","first-page":"115","DOI":"10.4137\/CCRep.S9675","article-title":"Obstructive hydrocephalus, fifth nerve and hypothalamus involvement: acute presentation of a giant prolactinoma","volume":"5","author":"Alkatari","year":"2012","journal-title":"Clin Med Insights Case Rep"},{"key":"2025082710080073000_18.1.e261540.16","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2019.00582","article-title":"Giant Prolactinoma Causing Hydrocephalus and Intracranial Hypertension as First Manifestations of Multiple Endocrine Neoplasia Type 1","volume":"10","author":"Dantas","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2025082710080073000_18.1.e261540.17","doi-asserted-by":"crossref","DOI":"10.25259\/SNI_1060_2022","article-title":"A case of acute hydrocephalus due to a giant prolactinoma rescued by transventricular neuroendoscopic tumorectomy","volume":"14","author":"Iwamura","year":"2023","journal-title":"Surg Neurol Int"},{"key":"2025082710080073000_18.1.e261540.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199410063311403"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261540","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:08:09Z","timestamp":1756314489000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,31]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-261540"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261540","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}