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June 15, 1984

Pituitary Tumor Initially Seen as Serous Otitis Media

Author Affiliations

From the Departments of Internal Medicine (Division of Endocrinology) (Drs Piziak and Gilliland), Internal Medicine (Dr Boyd), Surgery (Division of Otolaryngology) (Dr Brown), and Neurosurgery (Dr Smigiel), Scott and White Clinic, Temple, Tex.

JAMA. 1984;251(23):3131-3132. doi:10.1001/jama.1984.03340470057029

CEREBROSPINAL fluid otorrhea is commonly the result of temporal bone fracture; however, when not associated with trauma, it may initially resemble serous otitis media.1 The patient seen by the otolaryngologist has a sense of pressure in the ear or fluid in the middle ear. A persistence of symptoms in spite of adequate therapy for serous otitis media and profuse drainage of the ear after myringotomy and insertion of a tube should lead to additional diagnostic procedures to determine the cause of the persistent fluid. Cerebrospinal fluid otorrhea is occasionally associated with neoplasm of the CNS, such as cerebellopontine angle tumors and, rarely, meningomas.2 It has also been associated with empty-sella syndrome.3 This report describes a patient with a prolactinoma in whom the initial complaint was fullness in the ear and surgical drainage of the middle ear revealed CSF otorrhea.

Report of a Case  A 53-year-old man was