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Macroprolactinomas often present with hyperprolactinemia or space-occupying symptoms. There are few case reports of macroprolactinomas presenting as meningitis and CSF rhinorrhea. Presented is a case of a 51-year-old Chinese male who presented with meningitis and pneumonia, and thereafter, developed rhinorrhea. Magnetic Resonance Imaging of the brain revealed a macroprolactinoma. He subsequently underwent a trans-sphenoidal hypophysectomy to remove the tumor.