Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 18;21(6):94.
doi: 10.3892/mco.2024.2792. eCollection 2024 Dec.

Clinical parameters and postoperative outcomes of pituitary adenomas in children: Analysis according to size of adenomas and adopted surgical procedures

Xiangji Li  1 , Chunlei Tian  1 , Junlan Yao  2
Affiliations

Clinical parameters and postoperative outcomes of pituitary adenomas in children: Analysis according to size of adenomas and adopted surgical procedures

Xiangji Li et al. Mol Clin Oncol. .

Abstract

Pathologies of pediatric pituitary adenomas are uncommon and challenging to diagnose. Pituitary adenomas cause mass effects and neurological disruption in children. Postoperative evaluations of endocrine functions are challenging. The present study categorized adenomas by size and type, and evaluated outcomes based on the surgical procedures adopted. In addition, the present study analyzed the demographic parameters of children as well as the factors supposed to be influencing remission. Clinical characteristics, treatment parameters and postoperative outcomes of curative surgeries in 135 children [80 (59%) females and 55 (41%) males; age 12 (11-13) years at the time of first diagnosis] with pituitary adenomas who underwent curative surgeries operated between 1998 and 2023 in the Yichang Central People's Hospital, (Yichang, China) were included in the present retrospective study. A total of 112 (83%) children had microadenomas (<10 mm adenomas), 6 (4%) had macroadenomas (≥10 mm adenomas) and 17 (13%) had invisible adenomas. Pathological examination revealed that 59 (44%) children had functional adenomas and 10 (7%) had non-functional adenomas. Among functional adenomas, acromegaly (excess secretion of insulin-like growth factor 1) was reported to be the most common [30 (22%)] pediatric adenomas, followed by prolactinomas [prolactin secretion ≥1,000 mIU/l; 20 (15%) and Cushing syndrome (9 (7%)]. A total of 23 (17%), 3 (2%), 4 (3%), 3 (2%) and 3 (2%) children were reported to have remission and underwent re-surgery. These patients (remission) underwent microscopic trans-sphenoidal resection, endoscopic endonasal trans-sphenoidal resection, trans-sphenoidal resection alone, bilateral adrenalectomy and gross total resection adopted curative surgeries initially, respectively. Postoperative diabetes insipidus, adrenal insufficiency and cerebrospinal fluid leaks have been reported in children who have undergone curative surgeries for macroadenomas or Cushing syndrome. Female pediatric patients with clinical manifestations were more likely to have pituitary adenomas. Pediatric patients generally have functional pituitary adenomas, particularly adreno-corticotropin-secreting adenomas. Microscopic trans-sphenoidal resection is associated with a lower risk of under-treatment. Postoperative outcomes and clinical benefits of curative surgeries are based on the complete type of surgical removal and size of the pituitary adenomas mass (Level of Evidence: 3; Technical Efficacy Stage: 4).

Keywords: Cushing syndrome; acromegaly; functional adenomas; macroadenomas; microadenomas; microscopic trans-sphenoidal resection; pituitary adenoma; prolactinoma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the present study (according to pituitary adenomas size of adenomas).
Figure 2
Figure 2
Flow diagram of the present study (according to adopted curative surgeries for pituitary adenomas of adenomas).
Figure 3
Figure 3
A graphical presentation of clinical benefits of the adopted curative surgeries.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kilci F, Jones JH, Çaklılı M, Ceylan S, Çizmecioğlu-Jones FM. Clinical and therapeutic outcomes of pediatric pituitary adenomas: A single pituitary center experience. Endocrine. 2024;83:160–170. doi: 10.1007/s12020-023-03523-3. - DOI - PubMed
    1. Locatelli D, Veiceschi P, Castelnuovo P, Tanriover N, Evliyaoglu O, Canaz H, Ugurlar D, Gazioglu N. Transsphenoidal surgery for pituitary adenomas in pediatric patients: A multicentric retrospective study. Childs Nerv Syst. 2019;35:2119–2126. doi: 10.1007/s00381-019-04179-z. - DOI - PubMed
    1. Beckers A, Aaltonen LA, Daly AF, Karhu A. Familial isolated pituitary adenomas (FIPA) and the pituitary adenoma predisposition due to mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene. Endocr Rev. 2013;34:239–277. doi: 10.1210/er.2012-1013. - DOI - PMC - PubMed
    1. Guaraldi F, Storr HL, Ghizzoni L, Ghigo E, Savage MO. Paediatric pituitary adenomas: A decade of change. Horm Res Paediatr. 2014;81:145–155. doi: 10.1159/000357673. - DOI - PubMed
    1. Kelly AP, Greenfield JP, Dobri GA, Schwartz TH. 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. Childs Nerv Syst. 2022;38:729–738. doi: 10.1007/s00381-022-05445-3. - DOI - PubMed

LinkOut - more resources