Masked hyperprolactinemia: tumor-derived factors inhibiting prolactin secretion caused by pituitary-stalk damage.
Tumor-induced secondary hyperprolactinemia in patients with non-prolactin (PRL)-secreting pituitary tumors has traditionally been ascribed to pituitary stalk damage. We conducted a retrospective analysis of secondary hyperprolactinemia in 106 patients who underwent surgery for non-PRL-secreting pituitary adenoma. The incidence of hyperprolactinemia was evaluated, and pituitary-stalk damage was assessed radiographically using MRI (size of tumor and extension type) and endocrinologically by monitoring hormonal function using a provocation test. The effect of a tumor-derived intrasellar factor, leukemia inhibitory factor (LIF), on hyperprolactinemia was also investigated. Hyperprolactinemia was observed in 31 of the 106 (29.2%) patients. It was not correlated with either physical stalk compression or endocrinological dysfunction. However, LIF expression was negatively correlated with the incidence of secondary hyperprolactinemia (p<0.01). Although secondary hyperprolactinemia might be caused by pituitary stalk damage, it is possible that LIF masks the effect.
Department of Neurosurgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8551, Japan. y-kinoshita@hiroshima-u.ac.jp
Yasuyuki
Y
Kinoshita
Seiji
S
Hama
Atsushi
A
Tominaga
Kazunori
K
Arita
Kazuhiko
K
Sugiyama
Tetsuhiko
T
Sakoguchi
Satoshi
S
Usui
Kaoru
K
Kurisu
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011388:Prolactin / Q000097:blood* / Q000378:metabolism
D011388:Prolactin