Diagnóstico diferencial de los prolactinomas

Hyperprolactinemia may be due to both prolactin-secreting pituitary adenomas (prolactinomas) and nonfunctioning sellar tumors (so-called pseudoprolactinomas). The ratio between the size of the lesion and the degree of hyperprolactinemia usually allows prolactinomas to be distinguished from pseudoprolactinomas; this differential diagnosis is essential, since therapy is entirely different in each case (medical in the former, surgical in the latter). The possible coexistence of other physiologic, pathologic or iatrogenic causes for hyperprolactinemia, as well as laboratory artifacts (hook effect) and the presence of prolactin variants devoid of biological activity (macroprolactins) can give rise to errors. Clinicians should be aware of these conditions, since inappropriate treatments can result if they are not recognized. Copyrigth