Lesions in the hypothalamus or pituitary can cause hyperprolactinemia. Very small lesions may be a challenge to diagnose. Confirmation is achieved if the serum prolactin levels respond to control of the underlying disorder.
Hypothalamic or pituitary disorders associated with hyperprolactinemia:
(1) pituitary adenoma (functioning or nonfunctioning, may be manifestation of an MEN syndrome)
(2) other pituitary tumor, including metastases
(3) primary or secondary tumors of the hypothalamus
(4) sarcoidosis involving the hypothalamus or pituitary
(5) empty sella syndrome
(6) lymphocytic hypophysitis
(7) tuberculosis or other lesions infiltrating the pituitary and/or pituitary
(8) cranial irradiation
(9) vascular lesions affecting the hypothalamus or pituitary
(10) pseudotumor cerebri
(11) Carney complex
(12) McCune-Albright syndrome
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