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Hypopituitarism patterns and prevalence among men with macroprolactinomas

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Abstract

Purpose

Men with prolactin-secreting tumors usually harbor macroadenomas. The degree of pituitary dysfunction may vary among different adenoma size subgroups, as is recovery after treatment. Our study purpose was to characterize hypopituitarism and recovery after treatment in men with macroprolactinomas.

Methods

A retrospective study, including a consecutive group of 81 men with pituitary macroadenomas (≥10 mm) and hyperprolactinemia (>7×ULN). Patients were divided into three categories according to adenoma size at presentation: 10–19 mm (group A), 20–39 mm (group B), and ≥40 mm (group C). We compared total testosterone, gonadotropins, cortisol, thyroid hormones and hemoglobin levels at presentation and after treatment.

Results

Eighty-one patients were included; 24, 31 and 26 patients in groups A, B and C, respectively. Pretreatment hypogonadism prevalence was 75.0, 93.5 and 90.9 % (p = 0.046; A vs B and C), central hypocortisolism − 0, 6.9 and 33.3 % (p = 0.005), and central hypothyroidism − 6.7, 17.9 and 26.1 % (NS) in groups A, B and C, respectively. Only 26.7 % of all patients presented with hypocortisolism and/or hypothyroidism (42.9 % in group C). Anemia (Hb < 13.5 g %) was detected in 31.3, 57.1 and 80.0 % in groups A, B and C, respectively (p = 0.04). Larger adenoma diameter correlated strongly with lower FT4 levels following treatment (r = −0.42, p = 0.043).

Conclusions

Macroprolactinomas in men caused partial hypopituitarism, affecting testosterone in all adenoma size groups and cortisol more in patients with larger adenomas. However, most of the men did not have pituitary hormones affected, beside testosterone. Most patients recovered central hypocortisolism but not hypothyroidism following treatment.

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Acknowledgements

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Endocrinology, Rabin Medical Centre, Beilinson Campus, 49100, Petah Tiqva, Israel

    Amit Tirosh, Carlos Benbassat, Avner Lifshitz & Ilan Shimon

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Amit Tirosh, Carlos Benbassat & Ilan Shimon

Authors
  1. Amit Tirosh
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  2. Carlos Benbassat
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  3. Avner Lifshitz
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  4. Ilan Shimon
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Correspondence to Ilan Shimon.

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Tirosh, A., Benbassat, C., Lifshitz, A. et al. Hypopituitarism patterns and prevalence among men with macroprolactinomas. Pituitary 18, 108–115 (2015). https://doi.org/10.1007/s11102-014-0563-z

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  • DOI: https://doi.org/10.1007/s11102-014-0563-z

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