Diagnosis and management of pediatric sellar lesions

Pituitary region tumors in pediatric patients are largely comprised of craniopharyngiomas and pituitary adenomas, each with their unique considerations. Craniopharyngiomas account for the majority of pediatric sellar masses. Pituitary adenomas are relatively uncommon during childhood, although the incidence increases during adolescence. The diagnosis of sellar lesions involves a multidisciplinary effort, and detailed endocrinologic, ophthalmologic and neurologic testing are critical. The management of pituitary tumors varies depending on the entity. For most tumors, other than prolactinomas, transsphenoidal resection remains the mainstay of treatment. Less invasive modalities such as endoscopic transsphenoidal surgery, and stereotactic radiosurgery have shown promise as primary and adjuvant treatment modalities, respectively.