Pediatric Pituitary Adenomas: Early and Long-Term Surgical Outcome in a Series of 85 Consecutive Patients

Lina Raffaella Barzaghi, Marco Losa, Jody Filippo Capitanio, Luigi Albano, Giovanna Weber, Pietro Mortini

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Abstract

BACKGROUND: Young age has been reported as a negative prognostic factor for pituitary adenomas (PAs). They are very uncommon in children and adolescents; therefore, surgical outcomes are poorly described. OBJECTIVE: To report results of microsurgical transsphenoidal approach (MTSA) in pediatric PAs. METHODS: The study retrospectively analyzed 3040 PAs treated in our institute, according to the adenoma subtype and then divided into pediatric (≤18 yr) and adult groups (>18 yr). The average follow-up after surgery was 58 mo (n = 2906). RESULTS: In the pediatric group, the majority of adenomas were hormone-secreting (89.5%) with a female sex prevalence (78%) in prolactinomas and nonfunctioning pituitary adenomas (NFPAs); the maximum diameter of growth hormone (GH)-secreting adenomas was greater (28.1 ± 4.1 mm) than in adults (18 ± 0.3 mm, P =. 002). Surgical remission rate at 6 mo was similar in both groups for all adenoma subtypes: 72.1% and 76% in pediatric and adult Cushing's disease, 69.3% and 59.3% in prolactinomas, 55.6% and 61% in gigantism or acromegaly, 55.6% and 61.5% in NFPAs. Recurrences after remission occurred more frequently in pediatric GH-secreting adenomas compared to adults (40.0% vs 5.3%, P =. 028) despite similar follow-up (38 ± 17 and 48.1 ± 2.2 mo, P =. 7). Mortality was zero in the pediatric and 0.2% in the adult group (P =. 7); major morbidity was 2.4% and 2.2%, respectively (P =. 8). CONCLUSION: MTSA was safe and effective in children and adolescents as in adults, with the only exception of higher recurrence rate in pediatric GH-secreting adenomas. No complications related to young age appeared.

Original languageEnglish
Article numbernyy204
Pages (from-to)65-73
Number of pages9
JournalClinical Neurosurgery
Volume85
Issue number1
DOIs
Publication statusPublished - Jul 1 2019

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Keywords

  • Pediatric pituitary adenomas
  • Pituitary tumors
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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