Abstract | BACKGROUND: RESULTS: Receiver operating characteristic (ROC) curve analysis was performed, indicating that cut-off value of serum prolactin concentration to distinguish between non-functioning pituitary adenoma and prolactinoma was 38.6 ng/ml. Although it was statistically good accuracy (the area under the curve; 0.96, sensitivity; 0.99 and specificity; 0.81), the result did not fit the clinical situation as many false-positive cases (40 of 212, 18.9%) were included. Among them, mild hyperprolactinemia were shown in 9 (4.2%) and 53 (55.8%) non-functioning pituitary adenoma and prolactinoma, respectively. Four of 9 border zone patients with non-functioning pituitary adenoma were initially treated with dopamine agonists. Sequential head magnetic resonance imaging revealed no tumor shrinkage in all of them despite serum prolactin concentration was decreased. Surgery was chosen for them 24.6 months in average after the introduction of medication. CONCLUSIONS: Non-negligible number of patients with non-functioning pituitary adenoma presented unexpectedly high concentration of prolactin, fraught with a potential risk of misdiagnosis. While this equivocal population is not the majority, the prolactin cut-off value is not safely applicable. Especially for the patients with border zone prolactin concentration, meticulous follow up with sequential pituitary imaging is important.
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Authors | Tomohiro Kawaguchi, Yoshikazu Ogawa, Teiji Tominaga |
Journal | BMC research notes
(BMC Res Notes)
Vol. 7
Pg. 555
(Aug 20 2014)
ISSN: 1756-0500 [Electronic] England |
PMID | 25142896
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Hyperprolactinemia
(diagnosis)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Pituitary Gland
(pathology)
- Prolactin
(blood)
- ROC Curve
- Young Adult
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