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Discrimination of prolactinoma from hyperprolactinemic non-functioning adenoma

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Abstract

The objective of this study was to evaluate characteristics that discriminate prolactinoma from non-functioning pituitary macroadenoma with hyperprolactinemia. We included 117 patients with hyperprolactinemic pituitary macroadenomas. Patients were divided into three groups according to treatment outcomes and pathologic results: (A) prolactinoma that responded to dopamine agonist (DA) treatment (PRDA); (B) prolactinoma requiring surgical treatment (PRS); and (C) non-functioning pituitary adenoma with hyperprolactinemia (NFPAH). Old age, low serum prolactin levels, and extrasellar extension were associated with NFPAH. Most patients with NFPAH had serum prolactin levels less than 100 ng/ml. Visual defects and GH deficiency were more common in patients with NFPAH compared with patients with PRS and PRDA, without difference of tumor size. Galactorrhea and amenorrhea were less frequent in patients with NFPAH than in patients with PRS and PRDA. Post-operative remission of hyperprolactinemia was achieved in 100% of patients with NFPAH and in 72.5% of patients with PRS. DA administration was required in 25.5% of patients with PRS; however, no patients with NFPAH required DA administration. In conclusion, old age, extrasellar tumor extension with relatively low prolactin levels, visual defect, and GH deficiency were considered suggestive of non-functioning pituitary adenoma rather than prolactinoma in hyperprolactinemic pituitary macroadenoma.

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Acknowledgments

We are grateful to Suil Ji for performing the immunohistochemistry analyses used in this study. No potential conflict of interest relevant to this article was reported. Nothing to declare.

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Authors and Affiliations

  1. Endocrinology, Department of Internal Medicine, Institute of Endocrinology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Jae Won Hong & Eun Jig Lee

  2. Pathology Ilsan Hospital, Ilsan, Korea

    Mi Kyung Lee

  3. Department of Neurosurgery, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Sun Ho Kim

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  1. Jae Won Hong
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Correspondence to Sun Ho Kim or Eun Jig Lee.

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Hong, J.W., Lee, M.K., Kim, S.H. et al. Discrimination of prolactinoma from hyperprolactinemic non-functioning adenoma. Endocr 37, 140–147 (2010). https://doi.org/10.1007/s12020-009-9279-7

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  • DOI: https://doi.org/10.1007/s12020-009-9279-7

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