Abstract
Pituitary adenomas in childhood and adolescence constitute 2–6% of all operated pituitary adenomas. We report the clinical features, treatment and follow-up of 10 pediatric patients affected by pituitary adenomas. All patients underwent clinical evaluation, endocrine tests, magnetic resonance imaging and visual field assessment. Follow-up ranged from 8 to 132 months (median 52.6). All patients were older than 10 years of age; 60% were males. In 50% the initial complaints were headache and/or visual impairment, all except one had clear evidence of endocrine dysfunction. Ninety percent were macroadenomas. According to hormone measurements and immunostaining 50% were prolactinomas, 20% were pure GH-se-creting and 30% were non-functioning adenomas. Prolactinomas in two females were successfully treated with cabergoline. The other patients un-derwent surgery: three prolactinomas are still being treated with dopamine agonists and a GH-secreting adenoma is being treated with octreotide LAR and cabergoline. Two patients were also treated with conventional radiotherapy. Treatments were completely successful in 50% of patients: these have normal hormone secretion, full pubertal development, no significant tumor mass and normal visual field. Hypersecretion of prolactin persists in two cases; partial or complete hypopituitarism is present in four, relevant tumor remnant in another four and impairment of visual field is present in two cases. In conclusion, pediatric adenomas occur mostly in pubertal age, are prevalently macroadenomas and clinically functioning. Medical therapy should be preferred for secreting adenomas, but in some cases, notably prolactinomas in males, surgery and eventual radiotherapy may be needed.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Lüdecke D.K., Hermann H.D., Schulte F.J. Special problems with neurosurgical treatment of hormone-secreting pituitary adenomas in children. Prog. Exp. Tumor Res. 1987, 30: 362–370.
Fraioli B., Ferrante L., Celli P. Pituitary adenomas with onset during puberty. J. Neurosurg. 1983, 59: 590–595.
Dyer E.H., Civit T., Visot A., Delalande O., Derome P. Transsphenoidal surgery for pituitary adenomas in children. Neurosurgery 1994, 34: 207–212.
Haddad S.F., VanGilder J.C., Menezes A.H. Pediatric pituitary tumors. Neurosurgery 1991, 29: 509–514.
Kane L.A., Leinung M.C., Scheithauer B.W., Bergstralh E.J., Laws E.R. Jr, Grover R.V., Kovacs K., Horvath E., Zimermann D. Pituitary adenomas in childhood and adoles-cence. J. Clin. Endocrinol. Metab. 1994, 79: 1135–1140.
Mindermann T., Wilson C.B. Pediatric pituitary adenomas. Neurosurgery 1995, 36: 259–269.
Lafferty A.R., Chrousos G.P. Pituitary tumors in children and adolescents. J. Clin. Endocrinol. Metab. 1999, 84: 4317–4323.
Trainer P.J., Besser M. The Bart’s endocrine protocols. Churcill Livingstone, Edinburgh, 1995.
Lee A.G., Sforza P.D., Fard A.K., Repka M.X., Baskin D.S., Dauser C.R. Pituitary adenoma in children. J. Neurophthalmol. 1998, 18: 102–105.
Howlett T.A., Wass J.A.H., Grossman A., Plowman P.N., Charlesworth M., Touzel R., Rees L.H., Savage M.O., Besser G.M. Prolactinomas presenting as primary amenorrhea and delayed or arrested puberty: response to medical therapy. Clin. Endocrinol. (Oxf.) 1989, 30: 131–140.
Colao A., Loche S., Cappa M., Di Sarno A., Landi M.L., Sarnacchiaro F., Facciolli G., Lombardi G. Prolactinomas in children and adolescents. Clinical presentation and long term follow-up. J. Clin. Endocrinol. Metab. 1998, 83: 2777–2780.
Abe T., Abou Tara L., Lüdecke D.K. Growth hormone secreting pituitary adenomas in childhood and adolescence: features and results of transnasal surgery. Neurosurgery 1999, 45: 1–10.
Abe T., Lüdecke D.K., Saeger W. Clinically nonsecreting pituitary adenomas in childhood and adolescence. Neurosurgery 1998, 42: 744–751.
Magiakou M.A., Mastorakos G., Oldfield E.H., Gomez M.T., Doppman J.L., Cutler G.B., Nieman L.K., Chrousos G.P. Cushing’s syndrome in children and adolescents. N. Engl. J. Med. 1994, 331: 629–636.
Knappe U.J., Lüdecke D.K. Transnasal microsurgery in children and adolescents with Cushing’s disease. Neurosurgery 1996, 39: 484–493.
Savage M.O., Besser G.M. Cushing’s disease in childhood. Trends Endocrinol. Metab. 1996, 7: 213–216.
Maira G., Anile C. Pituitary adenomas in chilhood and adolescence. Can. J. Neurol. Sci. 1990, 17: 83–87.
Artese R., D’Osvaldo D.H, Molocznic I., Benencia H., Oviedo J., Burdman J.A., Basso A. Pituitary tumors in adolescent patients. Neurol. Res. 1998, 20: 415–417.
Oberfield S.E., Nino M., Riddick L., Pang S., Nagel M., Khandji A., Kairam R., Levine L.S. Combined bromocriptine and growth hormone (GH) treatement in GH-deficient children with macropro- lactinoma in situ. J. Clin. Endocrinol. Metab. 1992, 75: 87–90.
Tyson D., Reggiardo D., Sklar C., David R. Prolactin-secreting macroadenomas in adolescents. Response to bromocriptine therapy. Am. J. Dis. Child. 1993, 147: 1057–1061.
Weber A., Trainer P.J., Grossman A.B., Afshart F., Medbak S., Perry L.A., Plowman N., Rees L.H., Besser G.M., Savage M.O. Investigation, management and therapeutic out-come in 12 cases of childhood and adolescent Cushing’s sindrome. Clin. Endocrinol. (Oxf.) 1995; 43: 19–28.
Estrada J., Boronat M., Mielgo M., Magallon R., Millian I., Diez S., Lucas T., Barcelo B. The long-term outcome of pituitary irradiation after unsuccessful transsphenoidal surgery in Cushing’s disease. N. Engl. J. Med. 1997, 336: 172–177.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
De Menis, E., Visentin, A., Billeci, D. et al. Pituitary adenomas in childhood and adolescence. Clinical analysis of 10 cases. J Endocrinol Invest 24, 92–97 (2001). https://doi.org/10.1007/BF03343820
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03343820