Moreover, bleeding from the surgical area could cause widespread adhesion of the arachnoid membrane, resulting in CSF leakage or delayed CSF leakage (38).Besides, lower albumin levels of CSF may be a marker of the anti-inflammatory immune environment of invasive pituitary adenomas with higher infiltration of M2-like tumor-associated macrophages, which have an anti-inflammatory phenotype (39). Here, ALB is linked to pituitary gland adenoma.