++
For further information, see CMDT Part 26-04: Hyperprolactinemia
+++
Essentials of Diagnosis
++
+++
General Considerations
++
Table 26–1 lists causes of hyperprolactinemia
Augmentation or reduction mammoplasty, and mastectomy may stimulate PRL secretion
In acromegaly, there may be cosecretion of GH and PRL
Most are microadenomas (< 1 cm in diameter) that do not grow even with pregnancy or oral contraceptives
Some giant prolactinomas (> 3 cm in diameter) can spread into the cavernous sinuses and suprasellar areas; rarely, they may erode the floor of the sella to invade the paranasal sinuses
++
++
++
+++
Differential Diagnosis
++
Increased pituitary size is a normal variant in young women
10–25% of patients with hyperprolactinemia have macroprolactinemia, an increased circulating level of a high molecular weight PRL that is biologically inactive
See Table 26–1
++