Tumors associated with hyperprolactinemia
(1) intrasellar tumors other than pituitary adenomas, including metastases
(2) primary or secondary tumors of the hypothalamus
(3) breast cancer
(4) acute myeloblastic or lymphoblastic leukemia
(5) malignant lymphoma, either Hodgkins or non-Hodgkins
(6) lung cancer, especially neuroendocrine carcinomas
(7) nonpulmonary neuroendocrine carcinomas
(8) hypernephroma
where:
• The production of prolactin by a pituitary adenoma might not be classified as paraneoplastic since the cells normally produce the hormone.
• Intrasellar and hypothalamic tumors may exert pressure effects on the pituitary.
With paraneoplastic hyperprolactinemia:
(1) the patient's past history is negative for an elevated serum prolactin level prior to the appearance of the tumor (although a rise may precede its diagnosis)
(2) effective treatment of the tumor results in normalization of the serum prolactin levels
(3) relapse may be heralded by reappearance of the hyperprolactinemia
