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[Pubertal prolactin adenoma. Eight cases (author's transl)]
La Nouvelle Presse Medicale
|May 27, 1978
Summary
Pubertal onset of prolactin-secreting pituitary adenomas (PSPA) in adolescents can cause growth arrest or menstrual irregularities. Surgical outcomes depend on tumor size, with transsphenoidal surgery often restoring normal prolactin function.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Neurosurgery
Background:
- Prolactin-secreting pituitary adenomas (PSPA) are the most common type of pituitary adenoma.
- Adolescent-onset PSPAs are rare but can significantly impact growth and pubertal development.
Purpose of the Study:
- To investigate the clinical presentation, surgical management, and outcomes of PSPAs presenting during puberty.
- To differentiate clinical syndromes associated with early versus achieved puberty.
Main Methods:
- Retrospective analysis of 8 adolescent patients with histologically verified PSPAs.
- Sellar tomograms for tumor assessment (invasive vs. circumscribed).
- Surgical intervention (transsphenoidal or subfrontal) and post-operative management (bromocriptine, radiotherapy).
Main Results:
- Two distinct syndromes observed: growth/pubertal arrest in younger patients and amenorrhea/galactorrhea in those who had achieved puberty.
- Tumor invasiveness noted in 3 patients; circumscribed in 5.
- Transsphenoidal surgery in 7 patients resulted in normal prolactin function in 4.
Conclusions:
- Early diagnosis and surgical intervention are crucial for managing PSPAs in adolescents.
- Tumor size and surgical approach significantly influence post-operative outcomes.
- Bromocriptine is an effective adjunct therapy when surgical success is limited.