PD47-05 SERUM PREDICTORS OF PITUITARY TUMOR PRESENCE ON MRI

Abstract

You have accessJournal of UrologyCME1 May 2022PD47-05 SERUM PREDICTORS OF PITUITARY TUMOR PRESENCE ON MRI Jose M. Flores, Nicole Benfante, and John P. Mulhall Jose M. FloresJose M. Flores More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , and John P. MulhallJohn P. Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002615.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In clinical andrological practice, it is recommended that men with very low total testosterone (TT) levels as well as men with low TT/low LH with hyperprolactinemia should have a pituitary MRI to evaluate for a pituitary tumor (PT). What TT or prolactin levels mandate this, remains unclear. We aimed to define which TT and prolactin levels predicted PT presence on MRI. METHODS: The study population included men evaluated due to (i) low T (≤300 ng/dL) (ii) having early morning TT (iii) prolactin levels and (iv) brain/pituitary MRI. History of testosterone therapy or deprivation were exclusions. Early morning TT was measured using LCMS, and prolactin was assayed using an immunoassay. Prolactin level ≥20ng/mL was deemed high and TT ≤150 ng/dL profoundly low T. The MRI was read by a neuroradiologist. We attempted to evaluate predictors of PT presence using multivariable analysis. RESULTS: 57 patients were included. Mean age was 56±16 years. Mean TT = 146±101 ng/dL and mean prolactin = 11±11 ng/mL. A PT was diagnosed on MRI in 21% of these men. Median size was 0.7 (0.6, 1.4) cm. 58% had microadenoma, 33% macroadenoma and 9% other. 51% had profoundly low T and 16% high prolactin levels. 21% with TT <300 ng/dL had a PT diagnosed; 38% profoundly low T; 30% in men with elevated prolactin. Lower TT levels (OR=1.2) were the only predictor of PT. CONCLUSIONS: In men with low T, 1 in 5 had PT, which increased to 1 in 3 in men with high prolactin levels and up to 40% in profoundly low T. We observed that only lower T increased the likelihood of PT. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e795 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jose M. Flores More articles by this author Nicole Benfante More articles by this author John P. Mulhall More articles by this author Expand All Advertisement PDF DownloadLoading ...