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. 2022 Apr;38(4):729-738.
doi: 10.1007/s00381-022-05445-3. Epub 2022 Jan 19.

Pediatric pituitary adenomas are more aggressive, more likely to be hormone producing and are more difficult to cure than adult pituitary adenomas: case series and systematic literature review

Alexander P Kelly  1 , Jeffrey P Greenfield  2 , Georgiana A Dobri  2 , Theodore H Schwartz  3
Affiliations

Pediatric pituitary adenomas are more aggressive, more likely to be hormone producing and are more difficult to cure than adult pituitary adenomas: case series and systematic literature review

Alexander P Kelly et al. Childs Nerv Syst. 2022 Apr.

Abstract

Purpose: Pediatric pituitary adenomas (pPAs) are uncommon. Thus, their presentation and outcomes after treatment are less well-understood than those of pituitary adenomas in adulthood (aPAs).

Methods: A retrospective chart review was conducted for all patients who underwent endoscopic endonasal transsphenoidal surgery (EETS) for pPA at NewYork-Presbyterian Hospital/Weill Cornell Medicine (NYP/WCM) from 2005-2020. Eleven patients were identified, and information pertaining to age, sex, adenoma characteristics, procedural details, and outcomes was reviewed. A systematic review of the literature was also performed to compare outcomes of EETS versus microscopic endonasal transsphenoidal surgery (METS) for pPA.

Results: From 2005-2020, 11 patients underwent EETS for pPA at NYP/WCM. Mean age at operation was 14.9 ± 2.7 years, and 5 patients (45.5%) were male. 10 adenomas (90.9%) were hormone-producing. Of the functional adenomas, 8 (80.0%) were PRL-secreting and 2 (20.0%) were GH-secreting. Maximum adenoma diameter (MAD) ranged from 1.2-5.1 cm, with a median of 1.55 cm. Cavernous sinus invasion (CSI) occurred in 2 patients with macroprolactinoma. Gross total resection (GTR) was achieved in 10 (90.9%). Biochemical remission occurred in 5/10 (50.0%). Post-operative complications were documented in 8 cases (72.7%) and included diabetes insipidus, hypopituitarism, sinusitis, weight gain, cerebrospinal fluid leak, meningitis, and hydrocephalus. Systematic literature review of 105 microscopic and 175 endoscopic cases revealed high frequency of hormone-producing tumors (83.6%) and similar rates of GTR (82.4% vs 85.1%) and biochemical cure (75.8% vs 64.3%).

Conclusions: pPAs are more likely to be hormone producing and may be more aggressive and difficult to cure than aPAs. EETS is an effective treatment, although complication rates may be higher than in adult populations.

Keywords: Endonasal; Prolactinoma; Somatotropinoma; Transsphenoidal.

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References

    1. Perry A, Graffeo CS, Marcellino C, Pollock BE, Wetjen NM, Meyer FB (2018) Pediatric Pituitary Adenoma: Case Series, Review of the Literature, and a Skull Base Treatment Paradigm. J Neurol Surgery Part B Skull Base. Published Online. https://doi.org/10.1055/s-0038-1625984
    1. Walz PC, Drapeau A, Shaikhouni A et al (2019) Pediatric pituitary adenomas. Child’s Nerv Syst. Published online. https://doi.org/10.1007/s00381-019-04293-y - DOI
    1. Marino AC, Taylor DG, Desai B, Jane JA (2019) Surgery for Pediatric Pituitary Adenomas. Neurosurg Clin N Am. Published online. https://doi.org/10.1016/j.nec.2019.05.008 - DOI
    1. Wang H, Wang R, Hu T et al (2020) Nonfunctioning pituitary adenomas in pediatric and adolescent patients: a clinical analysis of a series of 14 patients. J Neurooncol. Published online. https://doi.org/10.1007/s11060-020-03512-w - DOI
    1. Broersen LHA, Biermasz NR, van Furth WR et al (2018) Endoscopic vs. microscopic transsphenoidal surgery for Cushing’s disease: a systematic review and meta-analysis. Pituitary. Published Online. https://doi.org/10.1007/s11102-018-0893-3

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