The diagnostic importance of prolactin subgroups in patients with stalk mass

Abstract

In some situations, the identification of subgroups of patients with elevated serum prolactin (PRL) levels on the basis of different forms of PRL present in the blood, may be complementary to generally accepted and performed biochemical and radiological examinations in addition to a thorough clinical evaluation. Further analysis of elevated PRL subgroups is advisable especially for cases lacking the signs of amenorrhea and galactorea harboring a space occupying lesion in the sellar region. We present the case report of a patient with a high ratio of macroprolactin with regard to total serum PRL harboring a radiologically confirmed stalk mass lesion. An appropriate treatment plan for this patient is discussed.

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“…This means that macroprolactinemia doesn't exclude the presence of prolactinoma. If macroprolactinemia was used to explain clinical manifestations of patients in which it coexists with abnormal MRI finding, it can result in the delay of diagnosis and redefinition of treatment to more conservative approach [37]. Idiopathic hyperprolactinemia occurs when elevated PRL levels are found in the absence of other recognizable causes of hyperprolactinemia [38].…”