International Journal For Multidisciplinary Research

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Giant prolactinoma presenting as stroke: an unusual case of facial Paralysis and Hemiparesis

Author(s) Dr. Meryem Eladla, Prof. Mohammed amine Essafi, Prof. Zineb Elazime, Prof. Hayat Aynaou, Prof. Houda Salhi
Country Morocco
Abstract Giant prolactinomas are rare pituitary tumors, usually responsible for compressive symptoms, but they may exceptionally present with neurological deficits mimicking an acute cerebrovascular event.
We report the case of an 88-year-old man admitted for right facial palsy associated with right hemiparesis, which prompted radiological investigations to rule out an ischemic stroke. Hypothalamic-pituitary magnetic resonance imaging (MRI) revealed a large central sellar mass suggestive of an invasive macroadenoma measuring 30 × 28 × 44 mm, with suprasellar extension and involvement of the third ventricle, resulting in active biventricular hydrocephalus. Serum prolactin levels were markedly elevated (600 ng/mL). Visual field examination demonstrated a right homonymous hemianopia.
Treatment with cabergoline (0.5 mg) was initiated, leading to significant clinical improvement within a few months. After twelve months of therapy, tumor volume had decreased by more than 30%, and serum prolactin levels were reduced by 96%.
This case highlights an unusual neurological presentation of a giant prolactinoma, occurring in the absence of both cerebrovascular accident and pituitary apoplexy.
Keywords Giant prolactinoma - stroke - facial Paralysis - Hemiparesis
Field Medical / Pharmacy
Published In Volume 8, Issue 3, May-June 2026
Published On 2026-05-08
DOI https://doi.org/10.36948/ijfmr.2026.v08i03.77314
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E-ISSN 2582-2160
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