Prolactin serum concentrations in childhood-onset craniopharyngioma patients.
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INTRODUCTION: Adamantinomatous craniopharyngiomas (CPs) are rare embryonic tumors originating from the sellar area. Neuroendocrine deficiencies affecting the hypothalamic-pituitary axes are well-known but the mechanisms underlying prolactin secretion in CP patients are unclear. This study analyzed the factors associated with prolactin serum concentrations in CP patients. METHODS: Patients with adamantinomatous CP, diagnosed as children, adolescents or young adults (< 26 years) were included in this study. In 98 cases, serum prolactin concentrations were measured before breakfast after fasting for at least 10 h, using an electrochemiluminescence assay, with concentrations analyzed for associations with diagnostic, clinical, and therapeutic parameters. RESULTS: Serum prolactin concentrations were within normal, age- and gender-specific ranges in 39 cases (38%), with decreased concentrations in 22 cases (21%) and elevated concentrations in 37 cases (36%). Factors positively associated with increased prolactin levels were age at CP diagnosis, degree of surgical resection, and suprasellar tumor location. Decreased prolactin levels correlated with irradiation and pituitary deficiencies of thyroid-stimulating hormone and vasopressin. Patients with decreased prolactin concentrations exhibited lower event-free survival. Prolactin concentrations were not associated with functional capacity, tumor volume, calcifications, or anthropometric parameters at diagnosis or at the time of study. CONCLUSIONS: Prolactin levels in CP patients are influenced by the impact of the tumor on the hypothalamic-pituitary axes, resulting in either increased or decreased serum concentrations. Prolactin levels could serve as a clinical marker for certain sequelae after CP diagnosis. Patients with abnormal prolactin levels should be monitored for signs of hypothalamic syndrome. CLINICAL TRIAL REGISTRATION NUMBERS: NCT00258453; NCT01272622; NCT04158284.