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Pediatric pituitary tumors.

S F Haddad1, J C VanGilder, A H Menezes

  • 1Division of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City.

Neurosurgery
|October 1, 1991
PubMed
Summary
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Pediatric pituitary tumors, primarily Cushing's disease and prolactinomas, were reviewed. Transsphenoidal surgery offered resolution for Cushing's disease but had variable success for prolactinomas in adolescents.

Area of Science:

  • Pediatric Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Pituitary tumors in pediatric patients present unique challenges.
  • Understanding pathological distribution and clinical course is crucial for effective management.

Purpose of the Study:

  • To define the pathological distribution, clinical presentation, treatment, and prognosis of pediatric pituitary tumors.
  • To analyze outcomes for Cushing's disease and prolactinomas in patients under 17 years of age.

Main Methods:

  • Retrospective review of 18 pediatric patients (7-17 years) treated between 1979-1989.
  • Evaluation of pathological subtypes, clinical symptoms, surgical interventions, and follow-up data.

Main Results:

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  • Five patients had Cushing's disease (adrenocorticotropic hormone-secreting tumors), all girls, with complete resolution after transsphenoidal surgery.
  • Thirteen patients had prolactinomas; girls presented with amenorrhea. Surgery had variable success, with 6 of 11 girls requiring further treatment.
  • Boys with prolactinomas required multimodal therapy including surgery and radiation for suprasellar extension.

    • Conclusions:

    • Transsphenoidal surgery is highly effective for pediatric Cushing's disease.
    • Management of pediatric prolactinomas, especially macroadenomas, requires tailored approaches due to variable surgical outcomes and potential need for adjuvant therapies.