Pituitary stalk thickening: neoplastic or not? - author's response to the letter by Wang et al.

We thank Dr Shirui Wang and colleagues for their interest in our recent publication on the distinction of neoplastic from non-neoplastic lesions in adult patients presenting with central diabetes insipidus (CDI) and pituitary stalk thickening (PST) (1). We acknowledge the fact that they could not confirm in their population our previous observation that a higher prolactin (PRL) concentration at diagnosis increases the likelihood of a neoplastic origin (2). As they mentioned, such an association of CDI and PST represents a rare and heterogeneous disorder, raising challenging issues in both diagnosis and management. It is interesting to mention that only 46 out of their original cohort of 321 patients with PST (3) were eligible for this comparative analysis. As there are limited data about the prevalence and significance of hyperprolactinemia in such patients, any additional insight is most welcome and worth to debate. [...