Pituitary tumors in childhood

Area of Science:

• Pediatric Endocrinology
• Pediatric Oncology
• Neuro-oncology

Background:

• Pituitary tumors in children, though often benign, cause significant morbidity and mortality due to proximity to critical brain structures.
• Disruption of pituitary hormone secretion is a major concern, impacting growth and development.
• Craniopharyngioma and prolactinoma are key pediatric pituitary tumor types discussed.

Purpose of the Study:

• To review recent literature on pediatric pituitary tumors, focusing on craniopharyngioma and prolactinoma.
• To highlight advances in understanding tumor formation and treatment modalities.
• To address challenges in managing these rare pediatric neoplasms.

Main Methods:

• Comprehensive literature review of recently published studies.
• Analysis of current understanding of molecular pathways in pituitary tumorigenesis.
• Evaluation of contemporary diagnostic and therapeutic approaches.

Main Results:

• Wingless/β-catenin signaling and aryl hydrocarbon receptor-interacting protein mutations are implicated in pituitary tumor development.
• While prolactinoma treatment is generally agreed upon, duration requires more study in children.
• Improved imaging, medical, surgical, and radiotherapy techniques have increased survival rates.
• Craniopharyngioma exhibits high recurrence and progression rates, especially after incomplete resection.
• Severe obesity is an increasingly recognized long-term sequela.

Conclusions:

• Craniopharyngioma remains a challenging pediatric sellar/parasellar mass with debated optimal treatment.
• A multidisciplinary approach, including radiotherapy and chemotherapy, is trending for hypothalamic craniopharyngiomas.
• More multicenter trials and standardized outcome assessments are needed for pediatric pituitary tumors.