{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T05:18:46Z","timestamp":1770959926289,"version":"3.50.1"},"reference-count":17,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report a man in the fifth decade of his life with an invasive giant prolactinoma (size: 7.3\u2005cm; serum prolactin 56820\u2005ng\/mL [SI: 2470.4\u2005nmol\/L], reference range, 5-25\u2005ng\/mL [SI: 0.22-1.09\u2005nmol\/L]) who presented with hypogonadism and headache. Dopamine agonist (DA) cabergoline (0.25\u2005mg twice weekly) was initiated, and serum prolactin levels reached 3941\u2005ng\/mL (SI: 171.3\u2005nmol\/L) after 2 doses. Two weeks later, he developed acute symptoms of headache, vomiting, and drowsiness associated with cerebrospinal fluid rhinorrhea. He presented to the casualty after 48\u2005hours of the onset of these acute symptoms in an altered state. Neuroimaging demonstrated extensive pneumocephalus with pneumoventricle. Cabergoline was discontinued, and an emergency neurosurgical repair was planned. Meanwhile, the patient's sensorium deteriorated, and he succumbed. Our case and review of 7 published cases of DA-induced pneumocephalus highlights male predominance, median tumor size of 5.5\u2005cm (range, 4-9.5\u2005cm), and onset within 1 to 12 weeks of initiation of DA therapy. Hence, for giant prolactinomas after DA initiation, it is essential to recognize the symptom complex associated with this rare life-threatening complication, pneumocephalus, and offer emergency surgical intervention.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf318","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T14:56:56Z","timestamp":1769612216000},"source":"Crossref","is-referenced-by-count":1,"title":["Dopamine Agonist Therapy Induced Fatal Pneumocephalus in Giant Prolactinoma"],"prefix":"10.1210","volume":"4","author":[{"given":"Archana","family":"M. H.","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Seth G. S. Medical College and K. E. M. Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7666-3929","authenticated-orcid":false,"given":"Anurag Ranjan","family":"Lila","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth G. S. Medical College and K. E. M. Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjiri","family":"Karlekar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth G. S. Medical College and K. E. M. Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba Samad","family":"Memon","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth G. S. Medical College and K. E. M. Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth G. S. Medical College and K. E. M. Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6902-4639","authenticated-orcid":false,"given":"Tushar","family":"Bandgar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth G. S. Medical College and K. E. M. Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"issue":"1","key":"2026012809565160100_luaf318-B1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1159\/000495184","article-title":"Giant prolactinomas","volume":"109","author":"Shimon","year":"2019","journal-title":"Neuroendocrinology"},{"issue":"6","key":"2026012809565160100_luaf318-B2","doi-asserted-by":"crossref","first-page":"R213","DOI":"10.1530\/EJE-14-0013","article-title":"Therapy of endocrine disease: the challenges in managing giant prolactinomas","volume":"170","author":"Maiter","year":"2014","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026012809565160100_luaf318-B3","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.ando.2023.10.005","article-title":"Giant prolactinoma in Asian-Indians: a single-center experience from Western India","volume":"84","author":"Kumar","year":"2023","journal-title":"Ann Endocrinol (Paris)"},{"issue":"12","key":"2026012809565160100_luaf318-B4","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"},{"issue":"2","key":"2026012809565160100_luaf318-B5","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1210\/jc.2010-1692","article-title":"Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline","volume":"96","author":"Melmed","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026012809565160100_luaf318-B6","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/cen.12242","article-title":"Giant prolactinomas: the therapeutic approach","volume":"79","author":"Moraes","year":"2013","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"2026012809565160100_luaf318-B7","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2012.4.FOCUS1268","article-title":"Spontaneous and medically induced cerebrospinal fluid leakage in the setting of pituitary adenomas: review of the literature","volume":"32","author":"Lam","year":"2012","journal-title":"Neurosurg Focus"},{"issue":"10","key":"2026012809565160100_luaf318-B8","doi-asserted-by":"crossref","first-page":"3829","DOI":"10.1210\/jc.2007-0373","article-title":"Nonsurgical cerebrospinal fluid rhinorrhea in invasive macroprolactinoma: incidence, radiological, and clinicopathological features","volume":"92","author":"Suliman","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"7872","key":"2026012809565160100_luaf318-B9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0140-6736(74)91639-0","article-title":"Assessment of coma and impaired consciousness. A practical scale","volume":"2","author":"Teasdale","year":"1974","journal-title":"Lancet"},{"issue":"5","key":"2026012809565160100_luaf318-B10","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1179\/acb.2009.078","article-title":"Pneumocephalus during cabergoline treatment of an invasive macroprolactinoma","volume":"64","author":"Jouret","year":"2009","journal-title":"Acta Clin Belg"},{"issue":"6","key":"2026012809565160100_luaf318-B11","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/S1130-1473(11)70110-5","article-title":"Neumoenc\u00e9falo a tensi\u00f3n causado por el tratamiento con cabergolina en un pacientecon prolactinoma invasivo gigante. A prop\u00f3sito de un caso [Cabergoline-induced tension pneumocephalus in a patient with giant invasive prolactinoma. Case report]","volume":"22","author":"Castro-Castro","year":"2011","journal-title":"Neurocirugia (Astur)"},{"issue":"10","key":"2026012809565160100_luaf318-B12","doi-asserted-by":"crossref","first-page":"3412","DOI":"10.1210\/jc.2012-2245","article-title":"Cabergoline-induced pneumocephalus in a medically treated macroprolactinoma","volume":"97","author":"Machicado","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"2026012809565160100_luaf318-B13","doi-asserted-by":"crossref","first-page":"bcr2013009986","DOI":"10.1136\/bcr-2013-009986","article-title":"Tension pneumocephalus after administration of two 0.25 mg cabergoline tablets in MEN1-related macroprolactinoma","volume":"2013","author":"Nanba","year":"2013","journal-title":"BMJ Case Rep"},{"issue":"2","key":"2026012809565160100_luaf318-B14","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jemermed.2018.04.006","article-title":"An unusual cause of tension pneumoventricle","volume":"55","author":"Lai","year":"2018","journal-title":"J Emerg Med"},{"issue":"1","key":"2026012809565160100_luaf318-B15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1046\/j.1365-2265.2000.00901.x","article-title":"CSF rhinorrhoea following treatment with dopamine agonists for massive invasive prolactinomas","volume":"52","author":"Leong","year":"2000","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2026012809565160100_luaf318-B16","doi-asserted-by":"crossref","first-page":"1179551418758640","DOI":"10.1177\/1179551418758640","article-title":"Cabergoline-induced pneumocephalus following treatment for giant invasive macroprolactinoma presenting with spontaneous cerebrospinal fluid rhinorrhea","volume":"11","author":"Elabd","year":"2018","journal-title":"Clin Med Insights Endocrinol Diabetes"},{"issue":"9","key":"2026012809565160100_luaf318-B17","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1001\/archneur.57.9.1366","article-title":"Mount fuji sign in tension pneumocephalus","volume":"57","author":"Sadeghian","year":"2000","journal-title":"Arch Neurol"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/2\/luaf318\/66611605\/luaf318.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/2\/luaf318\/66611605\/luaf318.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T14:56:58Z","timestamp":1769612218000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf318\/8443207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,1,8]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf318","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,1,8]]},"article-number":"luaf318"}}