Characteristics of mixed prolactin and adrenocorticotropin secreting pituitary adenomas and the differences in patients with merely prolactin-secreting adenomas.

OBJECTIVE

To evaluate the characteristics of pituitary adenomas that produce both prolactin and adrenocorticotropin.

METHODS

Between 2002 and 2011, we reviewed the data of 336 patients undergoing transsphenoidal surgery at Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. Patients were divided into 2 subgroups: patients with mixed prolactin and adrenocorticotropin secreting adenomas, and patients with merely prolactin-secreting adenomas. Clinical and endocrinological data, imaging, histopathological reports, and outcomes were reviewed. Differences between the 2 groups were statistically analyzed, and p<0.05 was considered statistically significant.

RESULTS

Compared to patients with merely prolactin-secreting adenomas, patients with mixed prolactin and adrenocorticotropin secreting adenomas were younger (p<0.001), had higher incidences of headaches and dizziness (p=0.021), progressive obesity (p<0.001), menstrual disorders (p=0.006), polyuria and polydipsia (p<0.001), hypertension (p=0.001), diabetes mellitus (p=0.001), and had higher rates of postoperative hyponatremia (p<0.001). Recurrence rates in patients with prolactin-secreting adenomas were 19.1% and patients with mixed prolactin and adrenocorticotropin secreting adenomas were 35.1% (p=0.023). However, the endocrine normalization rate in mixed prolactin and adrenocorticotropin secreting adenomas was lower (p=0.004).

CONCLUSIONS

Careful long-term follow-up is needed for patients with mixed prolactin and adrenocorticotropin secreting adenomas.