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Gender-related differences in prolactin secretion in pituitary prolactinomas
H Nishioka1, J Haraoka, K Akada
1Department of Neurosurgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Japan. nishioka@tokyo-med.ac.jp
Neuroradiology
|May 16, 2002
Summary
Serum prolactin (PRL) levels in pituitary prolactinomas correlate differently with tumor size in men versus women. However, after accounting for cysts and hemorrhage, this difference disappears, revealing similar PRL production between sexes.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Pituitary prolactinomas are tumors that secrete prolactin (PRL).
- Typically, serum PRL levels parallel tumor size in prolactinomas.
- Differences in PRL production between sexes with prolactinomas are not fully understood.
Purpose of the Study:
- To investigate gender-specific differences in PRL production relative to tumor volume in prolactinomas.
- To explore the impact of tumor characteristics like cysts and hemorrhage on PRL levels.
Main Methods:
- Retrospective study of 51 patients (16 men, 35 women) with prolactinomas.
- High-resolution magnetic resonance imaging (MRI) to estimate tumor volume (TV).
- Analysis of clinical, endocrinological, radiological, and histological findings, correlating PRL levels with TV, considering gender and tumor complications.
Main Results:
- Correlation between PRL level and TV was low in men (R=0.458) but high in women (R=0.953).
- Men predominantly had large tumors with high PRL levels and more frequent cyst formation.
- Hemorrhage and cysts in large prolactinomas were associated with reduced PRL secretion, and their exclusion normalized the PRL-TV correlation (R=0.905) across genders.
Conclusions:
- Intratumoral hemorrhage and cysts can cause a discrepancy between tumor size and PRL levels in prolactinomas.
- When adjusted for these factors, there is no fundamental difference in PRL secretion between men and women with prolactinomas.
- Sparsely granulated lactotroph adenoma with fibrosis is associated with hemorrhage and cysts.