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Updated: Feb 26, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
A retrospective review of 34 cases of pediatric pituitary adenoma
Nannan Zhang1, Peizhi Zhou1, Yu Meng2
1Department of Neurosurgery, West China Hospital, Sichuan University, 37th Guoxue Alley, Chengdu, China.
Insights
Pediatric pituitary adenomas show frequent invasive behaviors and apoplexy, with craniotomy being a viable option for complete tumor removal in children. Further research on pituitary adenoma apoplexy in this age group is recommended.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Oncology
Background:
- Pediatric pituitary adenomas are rare tumors requiring comprehensive understanding.
- Prior studies have yielded inconclusive results regarding invasiveness and clinical presentation.
Purpose of the Study:
- To investigate the invasiveness, tumor characteristics, and clinical symptoms of pediatric pituitary adenoma.
- To clarify discrepancies found in previous research.
Main Methods:
- Retrospective review of 34 pediatric patients (<20 years) surgically treated for pituitary adenoma (2010-2017).
- Analysis of clinical data, including symptoms, invasiveness, surgical approaches, and tumor features.
Main Results:
- Prolactinoma was the most common type, followed by GH-, none-, and ACTH-secreting adenomas.
- High incidence of invasive behaviors and macroadenomas (70%); increased pituitary adenoma apoplexy observed.
- Craniotomy and transsphenoidal surgery showed zero mortality; transient hypopituitarism and diabetes insipidus occurred in 9 cases.
Conclusions:
- Pediatric pituitary adenomas exhibit more frequent invasive behaviors than previously anticipated.
- Craniotomy is a recommended surgical approach for achieving total tumor resection.
- Pituitary adenoma apoplexy in children warrants further investigation due to distinct features compared to adults.
Purpose:
The purpose of this paper is to study invasiveness, tumor features and clinical symptoms of pediatric pituitary adenoma, and to discuss some inconclusive results in prior studies.
Methods:
We retrospectively reviewed 34 cases of children (<20 year-old) who were pathologically diagnosed with pituitary adenoma and surgically treated from 2010 to 2017. Data of general information, clinical symptoms, invasive behaviors, surgery approaches, and tumor features were collected and analyzed.
Results:
Sixteen boys and 18 girls aged from 12 to 19 years old were included. Prolactinoma was most suffered, followed by GH-, none- and ACTH-secreting pituitary adenoma. Invasive behaviors were observed frequently and suprasellar extensions were most found. Macroadenoma account 70% of all cases. Meanwhile, unlike prior studies, a significant raise of incidence on invasive tumor and pituitary adenoma apoplexy were observed. Craniotomy and transsphenoidal surgery were both applied with zero mortality. Nine cases occurred with transient hypopituitarism and diabetes insipidus. Three cases of tumor recurrence received secondary surgery or radiotherapy.
Conclusions:
Invasive behaviors were more frequent than previous prediction. Craniotomy is worth considering for total tumor removal. Pituitary adenoma apoplexy needs further studies since its different features between children and adults in present study. Specialized care and teamwork of neurosurgeons, pediatricians, and endocrinologists are important.
