Giant Prolactinoma and Cabergoline Side Effects: A Rare Case Study

Introduction: Giant prolactinomas are rare but serious pituitary adenomas, often requiring dopamine agonists like cabergoline for treatment. However, cabergoline can have unexpected side effects, as highlighted in this case study.

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Understanding Giant Prolactinomas

• Giant prolactinomas are pituitary tumors larger than 40mm, making up less than 5% of all prolactinomas.
• Symptoms vary but often include visual impairment, headaches, and hormonal imbalances.
• Treatment usually starts with dopamine agonists, with cabergoline being the first-line therapy.

Case Summary: Side Effects of Cabergoline

• A 33-year-old male presented with a giant prolactinoma (7×6 cm), experiencing visual loss and hormonal deficiencies.
• He was prescribed cabergoline but developed severe psychiatric side effects, including hallucinations and manic episodes.
• Due to these adverse effects, cabergoline was replaced with bromocriptine, which was better tolerated.

Medical Insights & External References The American Endocrine Society suggests dopamine agonists as the primary treatment for prolactinomas, but monitoring for psychiatric side effects is crucial. Learn more here.

Relevant Study Links

• Read the full study at https://doi.org/10.29328/journal.acr.1001031.
• Explore related research on prolactinomas in our journal archive here.

Managing Prolactinoma Treatment Risks

• Regular monitoring is essential for patients on dopamine agonists.
• Switching medications (e.g., from cabergoline to bromocriptine) can help manage side effects.
• In some cases, surgical intervention may be required when medical therapy fails.

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