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.
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.
Authors: T Feola; R Sa Pirchio; G Puliani; R Pofi; M Crocco; V Sada; F Sesti; F Verdecchia; D Gianfrilli; M Appetecchia; N Di Iorgi; M L Jaffrain-Rea; R Pivonello; A M Isidori; A B Grossman; E Sbardella Journal: J Endocrinol Invest Date: 2022-08-24 Impact factor: 5.467
Authors: Benjamin F Bitner; Brandon M Lehrich; Arash Abiri; Tyler M Yasaka; Frank P K Hsu; Edward C Kuan Journal: Pituitary Date: 2021-04-30 Impact factor: 4.107
Authors: Rosario Ferrigno; Valeria Hasenmajer; Silvana Caiulo; Marianna Minnetti; Paola Mazzotta; Helen L Storr; Andrea M Isidori; Ashley B Grossman; Maria Cristina De Martino; Martin O Savage Journal: Rev Endocr Metab Disord Date: 2021-01-30 Impact factor: 6.514