Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review

This study aims to summarize the clinical and pathological characteristics, as well as the treatment and therapeutic outcomes, of hyperprolactinemia caused by ectopic prolactin secretion. Case reports of patients with hyperprolactinemia caused by extra-pituitary prolactin secretion were collected by...

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Main Authors: Yixin Lu, Xiaoxue Chen, Xiaoan Ke, Lian Duan, Hongbo Yang, Hui Pan, Fengying Gong, Linjie Wang, Huijuan Zhu
Format: Article
Language:English
Published: Bioscientifica 2025-07-01
Series:Endocrine Connections
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Online Access:https://ec.bioscientifica.com/view/journals/ec/14/7/EC-25-0054.xml
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author Yixin Lu
Xiaoxue Chen
Xiaoan Ke
Lian Duan
Hongbo Yang
Hui Pan
Fengying Gong
Linjie Wang
Huijuan Zhu
author_facet Yixin Lu
Xiaoxue Chen
Xiaoan Ke
Lian Duan
Hongbo Yang
Hui Pan
Fengying Gong
Linjie Wang
Huijuan Zhu
author_sort Yixin Lu
collection DOAJ
description This study aims to summarize the clinical and pathological characteristics, as well as the treatment and therapeutic outcomes, of hyperprolactinemia caused by ectopic prolactin secretion. Case reports of patients with hyperprolactinemia caused by extra-pituitary prolactin secretion were collected by conducting searches in three databases using the terms (ectopic prolactin secretion) OR (ectopic hyperprolactinemia) OR (ectopic prolactinoma). Fifty-two cases were included (age: 45.5 years (34–55.25), baseline serum prolactin level: 218 ng/mL (110.3–680.5)). Extra-pituitary prolactin-secreting sites include ectopic pituitary adenomas (age: 55 years (47–65), baseline prolactin level: 382 ng/mL (200–1,598)) and non-pituitary-derived extracranial lesions (age: 38 years (30–45.5), baseline prolactin level: 148 ng/mL (75.25–246)). The most common symptoms of the two types of patients are, respectively, intracranial mass effect and galactorrhea or amenorrhea. 42.3% of cases received dopamine agonists as initial treatment, and among them, all patients with non-pituitary-derived lesions failed to achieve normalization in prolactin levels by receiving medication alone. 38.5% of cases received surgery as initial treatment, and 70% achieved an immediate decrease in prolactin level. In conclusion, hyperprolactinemia caused by ectopic prolactin secretion is rare, but it should still be considered in patients with hyperprolactinemia of unclear cause. Age, baseline prolactin levels, major symptoms, histology, pathology, and therapeutic outcomes varied between patients with prolactin-secreting ectopic pituitary adenomas and non-pituitary-derived lesions. Hyperprolactinemia caused by the latter had a female predominance. Dopamine agonists were effective for most ectopic pituitary adenomas, while patients with non-pituitary-derived lesions tended to resist dopamine agonists and responded well to surgery.
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series Endocrine Connections
spelling doaj-art-a884ae9dee354735b85fb59f370ff0802025-08-20T03:31:34ZengBioscientificaEndocrine Connections2049-36142025-07-0114710.1530/EC-25-00541Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic reviewYixin Lu0Xiaoxue Chen1Xiaoan Ke2Lian Duan3Hongbo Yang4Hui Pan5Fengying Gong6Linjie Wang7Huijuan Zhu8Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaThis study aims to summarize the clinical and pathological characteristics, as well as the treatment and therapeutic outcomes, of hyperprolactinemia caused by ectopic prolactin secretion. Case reports of patients with hyperprolactinemia caused by extra-pituitary prolactin secretion were collected by conducting searches in three databases using the terms (ectopic prolactin secretion) OR (ectopic hyperprolactinemia) OR (ectopic prolactinoma). Fifty-two cases were included (age: 45.5 years (34–55.25), baseline serum prolactin level: 218 ng/mL (110.3–680.5)). Extra-pituitary prolactin-secreting sites include ectopic pituitary adenomas (age: 55 years (47–65), baseline prolactin level: 382 ng/mL (200–1,598)) and non-pituitary-derived extracranial lesions (age: 38 years (30–45.5), baseline prolactin level: 148 ng/mL (75.25–246)). The most common symptoms of the two types of patients are, respectively, intracranial mass effect and galactorrhea or amenorrhea. 42.3% of cases received dopamine agonists as initial treatment, and among them, all patients with non-pituitary-derived lesions failed to achieve normalization in prolactin levels by receiving medication alone. 38.5% of cases received surgery as initial treatment, and 70% achieved an immediate decrease in prolactin level. In conclusion, hyperprolactinemia caused by ectopic prolactin secretion is rare, but it should still be considered in patients with hyperprolactinemia of unclear cause. Age, baseline prolactin levels, major symptoms, histology, pathology, and therapeutic outcomes varied between patients with prolactin-secreting ectopic pituitary adenomas and non-pituitary-derived lesions. Hyperprolactinemia caused by the latter had a female predominance. Dopamine agonists were effective for most ectopic pituitary adenomas, while patients with non-pituitary-derived lesions tended to resist dopamine agonists and responded well to surgery.https://ec.bioscientifica.com/view/journals/ec/14/7/EC-25-0054.xmlhyperprolactinemiaectopic prolactin secretionectopic prolactinomasectopic pituitary adenomas
spellingShingle Yixin Lu
Xiaoxue Chen
Xiaoan Ke
Lian Duan
Hongbo Yang
Hui Pan
Fengying Gong
Linjie Wang
Huijuan Zhu
Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review
Endocrine Connections
hyperprolactinemia
ectopic prolactin secretion
ectopic prolactinomas
ectopic pituitary adenomas
title Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review
title_full Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review
title_fullStr Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review
title_full_unstemmed Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review
title_short Hyperprolactinemia caused by extra-pituitary prolactin secretion: a systematic review
title_sort hyperprolactinemia caused by extra pituitary prolactin secretion a systematic review
topic hyperprolactinemia
ectopic prolactin secretion
ectopic prolactinomas
ectopic pituitary adenomas
url https://ec.bioscientifica.com/view/journals/ec/14/7/EC-25-0054.xml
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