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Transsphenoidal surgery for pituitary adenomas in children
1Department of Neurosurgery, Centre Medico-Chirurgical Foch, Suresnes, France.
Neurosurgery
|February 1, 1994
Summary
Transsphenoidal surgery is effective for pediatric pituitary adenomas, particularly ACTH-secreting tumors. However, success rates vary, with growth hormone-secreting tumors showing limited control and prolactinomas often needing additional therapies.
Area of Science:
- Pediatric Endocrinology
- Neurosurgery
- Oncology
Background:
- Pituitary adenomas are rare in children but can cause significant hormonal imbalances and mass effects.
- Transsphenoidal surgery is a primary treatment modality for pituitary adenomas.
Purpose of the Study:
- To evaluate the efficacy and outcomes of transsphenoidal surgery for pituitary adenomas in pediatric patients.
- To compare surgical results in children with different types of pituitary adenomas.
Main Methods:
- Retrospective review of 66 children (<16 years) who underwent transsphenoidal surgery for pituitary adenomas between 1966 and 1992.
- Analysis of tumor type, hormonal hypersecretion, surgical approach, recurrence rates, and long-term outcomes.
Main Results:
- Adrenocorticotropic hormone (ACTH)-secreting adenomas (Cushing's disease) had a high cure rate (78%) with surgery.
- Prolactinomas and growth hormone-secreting tumors showed lower surgical control rates, with many requiring adjuvant therapies.
- Suprasellar expansion was more common in pediatric prolactinomas and growth hormone-secreting tumors compared to adults.
Conclusions:
- Transsphenoidal surgery is a valuable treatment for pediatric pituitary adenomas, especially ACTH-secreting types.
- Outcomes vary significantly by tumor subtype, necessitating tailored treatment strategies.
- Further research is needed to optimize management for pediatric pituitary adenomas with limited surgical control.