Cerebrospinal Fluid Hormone Concentration in the Evaluation of Pituitary Tumors

Abstract

CSF concentrations of ACTH, growth hormone, thyrotropin, prolactin, luteinizing hormone and follicle stimulating hormone were measured in 28 patients with various neurologic disorders, 49 patients with pituitary tumors of whom 22 had suprasellar extension and 6 patients with craniopharyngiomas. With the exception of 1 patient with pseudotumor cerebri, CSF adenohypophyseal hormone concentrations were low in patients with neurologic disease and in patients with pituitary tumor without suprasellar extension. Twenty-one of 22 patients with suprasellar extension of a pituitary tumor and 2 of 6 patients with a craniopharyngioma had elevations of 1 or more CSF adenohypophyseal hormones. Posttreatment CSF adenohypophyseal hormone levels fell from previously elevated levels in 4 of 5 patients. These data suggest that an elevated CSF adenohypophyseal hormone concentration is a sensitive indicator of suprasellar extension of a pituitary tumor, and posttreatment measurements are useful in determining efficacy of therapy.