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Updated: Jun 4, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Pituitary adenomas in children: surgical course and functional outcome. Lille cohort retrospective study
Mélodie-Anne Karnoub1, Matthieu Vinchon1, Emilie Merlen2
1Lille University Hospital, Neurosurgery Department, PRISM Lab Inserm U1192, CHU LilleF-59000, Lille France.
Insights
Endoscopic endonasal surgery for pediatric pituitary adenomas is safe and effective, preserving pituitary function while achieving remission in most cases. This approach offers a successful treatment for children with these rare tumors.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Oncology
Background:
- Pituitary neuroendocrine tumors are rare in children.
- Treatment aims to cure the child and preserve pituitary function.
- Endoscopic endonasal resection is a key surgical approach.
Purpose of the Study:
- To describe the outcomes of pediatric patients undergoing endoscopic endonasal resection of pituitary adenomas.
- To evaluate the safety and efficacy of this surgical technique in children.
Main Methods:
- Retrospective study of pediatric patients (2007-2021) at Lille University Hospital.
- Data collected: age, surgical course, adenoma type, Knosp grade, resection extent.
- Follow-up maintained for at least 5 years.
Main Results:
- 26 pediatric patients included; 88% female. All adenomas were functioning (prolactinomas, ACTH-secreting, GH-secreting).
- Visual disturbances improved in 4/5 patients. Surgical course was consistently easy.
- High remission rates for prolactinomas (66%) and Cushing's disease (100%). Acromegaly required complementary treatment.
Conclusions:
- Endoscopic endonasal surgery is a safe and efficient approach for pituitary adenomas in children.
- Surgical treatment remains the mainstay for pediatric pituitary adenomas.
- This technique facilitates tumor resection while preserving pituitary function.
Context:
Pituitary Neuroendocrine Tumors are rare in children, but challenging, implying the two purposes to cure the child, and preserve pituitary function. In this paper, we describe our population of children who underwent endoscopic endonasal resection of a pituitary adenoma, in Lille University Hospital.
Patients And Methods:
Between 2007 and 2021, all children undergoing EEN surgery for pituitary adenoma were included. Age at surgery, surgical course, type of adenoma, knosp grade and extent of resection were collected.
Results:
26 patients were included. 88% were female. All adenomas were functioning. 15 patients had prolactine-secreting adenomas (58%), 9 patients had ACTH-secreting adenomas (35%) and 2 patients had GH-secreting adenomas (8%). Visual disturbance was present at diagnosis in 5 patients. Among them, visual function was improved after surgery in 4 patients and stable in one. Surgical course was always easy. 66% of prolactinomas, all Cushing disease were in remission after surgery. The two patients with acromegaly had to undergo complementary treatment. Follow up was maintained at least 5 years.
Discussion:
Surgical treatment remain mainstay in pituitary adenomas. In the pediatric population, surgery can be performed safely and efficiently via en EEN approach.
