Management of pediatric sellar tumors

Craniopharyngiomas and pituitary adenomas are the most common forms of sellar tumors in children. First-line treatment usually consists of surgical resection of the tumor, although dopamine agonist therapy may be considered as first-line therapy in most patients with prolactin-secreting adenomas. Transsphenoidal resection has become increasingly widespread and represents the mainstay of surgical therapy for pituitary adenomas and selected craniopharyngiomas. Radical surgery, while appropriate in most patients, carries increased risks of postoperative morbidity, mortality and endocrinopathy. Other less invasive treatments include intracavitary therapy and debulking followed by radiation therapy or stereotactic radiosurgery. Overall, the management of these tumors requires a multidisciplinary approach.