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Pituitary tumors in children: clinical analysis of 21 cases
1Department of Neurological Surgery, Dr Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. mehrazin@yahoo.com
Insights
Pediatric pituitary adenoma surgery outcomes were reviewed in 21 children. These tumors appear more aggressive in children, with a high risk of pituitary apoplexy.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Oncology
Background:
- Pituitary adenomas are tumors of the pituitary gland.
- Pediatric pituitary adenomas present unique challenges compared to adult cases.
Purpose of the Study:
- To review surgical outcomes for pituitary adenomas in patients under 18 years old.
- To analyze tumor types, management strategies, and outcomes in pediatric pituitary adenoma patients.
Main Methods:
- Retrospective review of 21 pediatric patients (age < 18) treated between 1979-2003.
- Analysis of tumor hormone secretion, management (surgery, reoperation, radiotherapy, pharmacotherapy), and follow-up duration.
Main Results:
- Hormone-secreting tumors included ACTH (38.1%), prolactin (33.3%), and growth hormone (19%).
- Eleven patients required reoperation and radiotherapy, often for prolactinomas, acromegaly, or nonfunctioning adenomas.
- Two deaths occurred; one due to pituitary apoplexy.
Conclusions:
- Pediatric pituitary adenomas exhibit more aggressive biological behavior than adult adenomas.
- There is a high incidence of pituitary apoplexy in pediatric invasive pituitary adenomas.
Objective:
The aim of this study is to review the results of surgery for pituitary adenomas in children less than 18 years old.
Materials And Methods:
A retrospective review was done of pituitary adenoma patients with the age of less than 18 years who were treated in the period 1979-2003 at Dr. Shariati Hospital.
Conclusions:
Twenty-one patients (12 girls and 9 boys) were identified. The age range (mean) in girls and boys was 9-18 (15.8) and 9-17 (14.8) years, respectively. The duration of follow-up was 1-23 (13.4) years. Eight patients (38.1%) had adrenocorticotropic hormone-secreting tumors, 33.3% had prolactin-secreting tumors, 19% had growth hormone-secreting tumors, and 9.53% had nonfunctioning adenomas. Multidisciplinary management included surgery and, if necessary, reoperation with/without radiotherapy and pharmacotherapy. Eleven patients, mostly with prolactinomas, acromegaly, and nonfunctioning adenomas, needed reoperation and radiotherapy. There were two deaths, one of which was because of apoplexy. The biological behavior of pediatric pituitary adenomas seems more aggressive than adults' adenomas. The chance of pituitary apoplexy in pediatric invasive pituitary adenoma is high.
