Foster Kennedy syndrome secondary to a giant prolactinoma with a remarkable response to cabergoline.
Kanj, Usama Lee, Sam Sum Wattegama, Milanka Chavda, Swarupsinh Karavitaki, Niki Batra, Ruchika
Kanj, Usama
Lee, Sam Sum
Wattegama, Milanka
Chavda, Swarupsinh
Karavitaki, Niki
Batra, Ruchika
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2022-08-01
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Summary: Pituitary adenomas are intracranial neoplasms, usually demonstrating a benign phenotype. We present the case of 21-year-old male with an 18-month history of reduced visual function (acuity and field) in the left eye. Based on neuroimaging and endocrine profile, a giant prolactinoma causing hypogonadotropic hypogonadism was diagnosed and cabergoline was commenced. After a month of treatment, the tumour size reduced, and visual function improved to normal; however, he developed Foster Kennedy syndrome with a swollen right optic disc. After almost 1 year of follow-up, he regained full visual functioning. Two years since his diagnosis, his prolactin remains normal with no adverse effects or further visual complications.
Learning points: Foster Kennedy syndrome is a rare entity but can be a feature of pituitary adenomas. Visual deterioration secondary to a compressive optic neuropathy can be reversible, provided that diagnosis and treatment are prompt. This case highlights the importance of frequent monitoring of visual function during follow-up of these lesions, particularly when there are deficits at diagnosis.
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Kanj U, Lee SS, Wattegama M, Chavda S, Karavitaki N, Batra R. Foster Kennedy syndrome secondary to a giant prolactinoma with a remarkable response to cabergoline. Endocrinol Diabetes Metab Case Rep. 2022 Aug 1;2022:22-0261. doi: 10.1530/EDM-22-0261. Epub ahead of print
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