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).

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