Related Experiment Video
Updated: Aug 20, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
The evolution of pituitary cysts in growth hormone-treated children
Matthew D Krasnow1, Nicholas A Krasnow1, Liam McGuirk1
1Department of Pediatrics, Division of Pediatric Endocrinology, New York Medical College, Valhalla, NY, USA.
Insights
Pituitary cysts in children can change size significantly during growth hormone treatment. Monitoring the percent of the pituitary gland occupied by the cyst (POGO) is crucial for assessing potential impacts on pituitary function.
Area of Science:
- Pediatric endocrinology
- Neuroimaging
- Endocrine oncology
Background:
- Pituitary cysts are known to potentially impact growth hormone secretion.
- Understanding cyst evolution is key to managing endocrine disorders in children.
Purpose of the Study:
- To investigate the changes in pituitary cyst size during growth hormone treatment in pediatric patients.
- To evaluate the relationship between cyst size, gland volume, and treatment duration.
Main Methods:
- Retrospective analysis of 49 children with short stature and pituitary cysts.
- Calculation of the Percent of the Pituitary Gland Occupied by the cyst (POGO) using MRI data.
- Classification of cysts as small (POGO ≤15%) or large (POGO >15%) for comparative analysis.
Main Results:
- Cyst volume and POGO showed significant variability over time, with small cysts growing and large cysts shrinking.
- Older patients exhibited larger pituitary volumes and cyst volumes, though POGO differences were not significant.
- While small cysts had a higher percentage change in volume, large cysts demonstrated a greater absolute change in cyst volume.
Conclusions:
- Pituitary cyst size is dynamic and can fluctuate significantly during growth hormone therapy.
- POGO is a valuable metric for assessing the pathological impact of pituitary cysts on endocrine function.
- Close monitoring of large pituitary cysts is recommended due to their unpredictable behavior.
Objectives:
We have previously shown that pituitary cysts may affect growth hormone secretion. This study sought to determine cyst evolution during growth hormone treatment in children.
Methods:
Forty-nine patients with short stature, a pituitary cyst, and at least two brain MRI scans were included. The percent of the pituitary gland occupied by the cyst (POGO) was calculated, and a cyst with a POGO of ≤15% was considered small, while a POGO >15% was considered large.
Results:
Thirty-five cysts were small, and 14 were large. Five of the 35 small cysts grew into large cysts, while 6 of the 14 large cysts shrunk into small cysts. Of 4 cysts that fluctuated between large and small, 3 presented as large and 1 as small. Small cysts experienced greater change in cyst volume (CV) (mean=61.5%) than large cysts (mean=-0.4%). However, large cysts had a greater net change in CV (mean=44.2 mm3) than small cysts (mean=21.0 mm3). Older patients had significantly larger mean pituitary volume than younger patients (435.4 mm3 vs. 317.9 mm3) and significantly larger mean CV than younger patients (77.4 mm3 vs. 45.2 mm3), but there was no significant difference in POGO between groups.
Conclusions:
Pituitary cyst size can vary greatly over time. Determination of POGO over time is a useful marker for determining the possibility of a pathologic effect on pituitary function since it factors both cyst and gland volume. Large cysts should be monitored closely, given their extreme, erratic behavior.
Related Concept Videos
01:27Hormones of the Pituitary Gland
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
01:17The Pituitary Gland
01:10Nature and Nurture
01:27Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
01:27Major Hormones and Their Functions
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...