Pediatric Pituitary Adenomas and Cysts: A 46-Year Population-Based Analysis

Area of Science:

• Pediatric Endocrinology
• Neuro-oncology
• Epidemiology

Background:

• Pituitary adenomas and cysts are uncommon in children, necessitating a better understanding for effective management.
• Improved knowledge of pediatric pituitary lesions can inform clinical practice guidelines.

Purpose of the Study:

• To determine the incidence, clinical presentation, management, and outcomes of pituitary adenomas and cysts in a pediatric population.
• To investigate correlations between lesion characteristics (size, headaches) and disease progression, and MRI rates.

Main Methods:

• Retrospective cohort study of pediatric patients (≤18 years) with pituitary adenomas/cysts in Olmsted County, MN (1976-2021).
• Utilized Rochester Epidemiology Project diagnostic codes to identify 37 confirmed cases from 234 unique patients.
• Calculated incidence rates and analyzed clinical data using descriptive statistics.

Main Results:

• Incidence was 2.29 cases per 100,000 person-years.
• Most common types were nonfunctioning (68%) and prolactinomas (27%); GH- and TSH-secreting adenomas were rare.
• Median lesion size was 5.5 mm; median follow-up was 7.4 years. Disease progression occurred in 4 patients, stabilizing with treatment. No significant correlation found between MRI rates, lesion size, or headaches and disease progression.

Conclusions:

• Pediatric pituitary adenomas and cysts are rare, often small, nonfunctioning, and demonstrate stability during long-term follow-up.
• Further large-scale studies are required to elucidate the natural history of small, nonfunctioning pituitary lesions and refine management recommendations.