Prolactinomas in children and adolescents

Area of Science:

• Pediatric Endocrinology
• Neuro-oncology
• Tumor Biology

Background:

• Prolactinomas are the most frequent pituitary adenomas in pediatric populations.
• Females are more commonly affected, and macroadenomas are more prevalent in children than adults.
• Diagnosis relies on clinical signs of gonadal dysfunction, growth issues, or tumor compression.

Purpose of the Study:

• To outline the diagnostic criteria and treatment strategies for pediatric prolactinomas.
• To differentiate pediatric prolactinoma characteristics from adult cases.
• To emphasize the role of dopamine agonists as a primary treatment modality.

Main Methods:

• Review of clinical presentations and diagnostic findings in pediatric prolactinoma patients.
• Analysis of treatment outcomes with dopamine agonists, surgery, and radiotherapy.
• Comparison of epidemiological and clinical features between pediatric and adult prolactinoma cases.

Main Results:

• Prolactinomas are the leading pituitary adenoma type in children, followed by ACTH- and GH-secreting adenomas.
• Macroadenomas are more common in pediatric patients compared to microadenomas.
• Dopamine agonists are the first-line treatment for managing prolactin levels and tumor size.

Conclusions:

• Medical therapy with dopamine agonists is the cornerstone of prolactinoma treatment in children.
• Surgery is reserved for dopamine-agonist-resistant tumors or those with severe neurological symptoms.
• Radiotherapy is a last resort for aggressive, unresponsive tumors due to potential long-term side effects.