# Ectopic Sphenoid Sinus Prolactinoma Associated With Empty Sella and Recurrent Meningitis Treated Successfully With Cabergoline

## TL;DR

A rare case of an ectopic prolactinoma in the sphenoid sinus was successfully treated with cabergoline, alongside empty sella and recurrent meningitis.

## Contribution

This case report presents a rare successful treatment of ectopic prolactinoma with dopamine agonists and highlights its unusual clinical presentation.

## Key findings

- An 8 mm ectopic prolactinoma in the sphenoid sinus was diagnosed with MRI and CT.
- Cabergoline normalized the patient's elevated prolactin levels and caused regression of the tumor.
- The case highlights the rare co-occurrence of ectopic pituitary adenoma, empty sella, and meningitis.

## Abstract

Ectopic pituitary adenomas (EPA) are tumors that reside outside the sella turcica and are not connected to the pituitary gland. We present a case of a 62-year-old female who was hospitalized for recurrent meningitis. Workup, including magnetic resonance imaging (MRI) of the brain, computed tomography (CT) of the sinuses, and follow-up MRI of the sella turcica, revealed an 8 millimeter (mm) mass in the right posterior sphenoid sinus with an empty sella turcica and no evidence of a sellar mass. The mass was biopsied, with pathology results showing findings of a pituitary adenoma staining positive for prolactinoma. Subsequent hormonal workup revealed an elevated prolactin level of 128.4 nanograms per milliliter (ng/mL) without evidence of additional hormonal co-secretion or hypopituitarism. The patient was started on cabergoline with eventual normalization of the prolactin level and regression of the adenoma on follow-up imaging. EPAs are rare and thus treatment guidelines have not been established. Our case report not only highlights a case of successful treatment of ectopic prolactinoma with dopamine agonist therapy but also calls attention to the uncommon co-existence of EPAs and empty sella turcica and meningitis as an extremely uncommon presentation of EPAs.