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Published on: January 17, 2018
Pituitary Adenomas in Children: : Specific Imaging Features According to Hormonal Secretion
Fares Kassem1,2,3, Raphael Levy1,2,3, Arnault Tauziède-Espariat4
1Hôpital Universitaire Necker-Enfants Malades, Department of Pediatric Radiology, AP-HP, 149 rue de Sèvres, 75015, Paris, France.
Insights
Pediatric pituitary adenomas, though rare, exhibit distinct imaging features. Larger, more aggressive tumors with higher T2 signal intensity may indicate lactotroph or somatotroph adenomas in children.
Area of Science:
- Pediatric Endocrinology
- Neuroradiology
- Oncology
Background:
- Pituitary adenomas are uncommon in pediatric populations compared to adults.
- Understanding their specific imaging characteristics is crucial for diagnosis and management in children.
Purpose of the Study:
- To analyze the imaging features of pituitary adenomas in children.
- To compare these characteristics based on hormonal secretion type.
Main Methods:
- Retrospective observational study of clinical and imaging data from 31 children with pituitary adenomas.
- Assessment of tumoral signal intensity (T1, T2), volume, and aggressiveness.
- Comparison of imaging features across different hormonal secretion types (lactotroph, corticotroph, somatotroph, plurihormonal).
Main Results:
- Lactotroph and somatotroph adenomas were larger and more aggressive than corticotroph adenomas.
- Tumors associated with lactotroph and somatotroph adenomas showed higher T2-weighted signal intensity.
- MEN1 mutations were identified in 80% of the 20 children genetically tested.
Conclusions:
- Imaging characteristics of pediatric pituitary adenomas can suggest the underlying hormonal secretion.
- While rare, pituitary adenomas in children share some imaging similarities with adult counterparts.
- Genetic analysis revealed a high prevalence of MEN1 mutations in this cohort.
Purpose:
Pituitary adenomas are much rarer in children than in adults. We aimed to analyze their imaging characteristics in this age group and to compare them according to the hormonal secretion. We conducted an observational monocentric retrospective study on clinical and imaging data.
Methods:
We analyzed imaging features before surgery or drug treatment of pituitary adenomas in children confirmed by histopathology or hormonal secretion. We assessed tumoral signal intensity, volume and aggressiveness, and compared it according to the hormonal secretion.
Results:
We included 31 children (13 lactotroph (42%), 8 corticotroph (26%), 5 somatotroph (16%), 5 plurihormonal adenomas (16%) including 1 non-secreting macroadenoma) with a median age of 13 years (range 2-16 years-old), without age or sex difference between secretion types. Lactotroph and somatotroph adenomas were larger than corticotroph adenomas (p = 0.007) and were more aggressive (p = 0.01). They also had higher signal intensity on T2-weighted images (p = 0.04). T1 signal intensity was similar between the groups on pre and post-contrast images (lower enhancement than the normal pituitary). No non-secreting micro-adenoma became clinically significant enough to lead to a pathological confirmation or specific treatment. Genetic research was conducted on 20 children, finding MEN1 mutations in 80% of the patients.
Conclusions:
Pituitary adenomas in children are rare but should be considered when facing similar imaging features than in adults. Imaging characteristics may allow to suspect the hormonal secretion.
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