Poor correlation of serum α-subunit concentration and magnetic resonance imaging following pituitary surgery in patients with nonfunctional pituitary macroadenomas

Maria M. Pineyro, Antoine Makdissi, Charles Faiman, Richard A. Prayson, Sethu K. Reddy, Marc C. Mayberg, Robert J. Weil, Amir H. Hamrahian

Research output: Contribution to journalArticle

Abstract

Objective: To review the clinical utility of measuring serum α-subunit as a marker for residual tumor in a group of patients with surgically resected nonfunctional pituitary adenomas. Methods: In this retrospective cross-sectional chart review using the pituitary database at the Cleveland Clinic, we identified patients with nonfunctional pituitary macroadenomas over a 4-year period (2000-2004) and selected those patients who had an elevated α-subunit concentration measured before pituitary surgery. Presurgery and postsurgery measurements of α-subunit, luteinizing hormone, follicle-stimulating hormone, and thyroid-stimulating hormone were documented. Findings from preoperative and postoperative pituitary magnetic resonance imaging (MRI) were reviewed. Results: We identified 54 patients who were evaluated for nonfunctional pituitary macroadenomas during the study period. Of the 39 who underwent pituitary surgery, 34 had a serum α-subunit concentration measured before surgery. Eight of 34 patients had elevated preoperative α-subunit levels with a median value of 1.8 ng/mL (range, 1.0-3.4 ng/mL). Of the 8 patients, 7 had follow-up MRI a median of 12 months (range, 6-52 months) after surgery. One patient was lost to follow-up. Three of 7 patients had persistently elevated α-subunit levels postoperatively; in 2 of these 3, MRI did not identify residual tumor. Among the 4 patients with postoperative normalization of α-subunit, 2 patients had residual tumor on MRI. Conclusion: The discrepancy between α-subunit levels and postoperative MRI calls into question the value of routine α-subunit measurement as a tumor marker in patients with nonfunctional pituitary macroadenomas.

Original languageEnglish (US)
Pages (from-to)452-457
Number of pages6
JournalEndocrine Practice
Volume14
Issue number4
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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