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Erschienen in: Child's Nervous System 4/2007

01.04.2007 | Original Paper

Pituitary tumors in children: clinical analysis of 21 cases

verfasst von: M. Mehrazin

Erschienen in: Child's Nervous System | Ausgabe 4/2007

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Abstract

Objective

The aim of this study is to review the results of surgery for pituitary adenomas in children less than 18 years old.

Materials and methods

A retrospective review was done of pituitary adenoma patients with the age of less than 18 years who were treated in the period 1979–2003 at Dr. Shariati Hospital.

Conclusions

Twenty-one patients (12 girls and 9 boys) were identified. The age range (mean) in girls and boys was 9–18 (15.8) and 9–17 (14.8) years, respectively. The duration of follow-up was 1–23 (13.4) years. Eight patients (38.1%) had adrenocorticotropic hormone-secreting tumors, 33.3% had prolactin-secreting tumors, 19% had growth hormone-secreting tumors, and 9.53% had nonfunctioning adenomas. Multidisciplinary management included surgery and, if necessary, reoperation with/without radiotherapy and pharmacotherapy. Eleven patients, mostly with prolactinomas, acromegaly, and nonfunctioning adenomas, needed reoperation and radiotherapy. There were two deaths, one of which was because of apoplexy. The biological behavior of pediatric pituitary adenomas seems more aggressive than adults’ adenomas. The chance of pituitary apoplexy in pediatric invasive pituitary adenoma is high.
Literatur
1.
Zurück zum Zitat Abe T, Tara LA, Ludecke DK (1999) Growth hormone-secreting pituitary adenomas in childhood and adolescence: features and results of transnasal surgery. Neurosurgery 45:1–10PubMedCrossRef Abe T, Tara LA, Ludecke DK (1999) Growth hormone-secreting pituitary adenomas in childhood and adolescence: features and results of transnasal surgery. Neurosurgery 45:1–10PubMedCrossRef
2.
Zurück zum Zitat Abe T, Ludecke DK, Saeger W (1998) Clinically nonsecreting pituitary adenomas in childhood and adolescence. Neurosurgery 42:744–750PubMedCrossRef Abe T, Ludecke DK, Saeger W (1998) Clinically nonsecreting pituitary adenomas in childhood and adolescence. Neurosurgery 42:744–750PubMedCrossRef
3.
Zurück zum Zitat Artese R, D’Oslavalo DH, Mollocznik I et al (1998) Pituitary tumors in adolescent patients. Neurol Res 20:415–417PubMed Artese R, D’Oslavalo DH, Mollocznik I et al (1998) Pituitary tumors in adolescent patients. Neurol Res 20:415–417PubMed
4.
Zurück zum Zitat Bills DC, Meyer FB, Laws ER Jr, Davis DH, Ebersold MJ, Scheithauer BW, Ilstrup DM, Abboud CF (1993) A retrospective analysis of pituitary apoplexy. Neurosurgery 33(4):602–608PubMedCrossRef Bills DC, Meyer FB, Laws ER Jr, Davis DH, Ebersold MJ, Scheithauer BW, Ilstrup DM, Abboud CF (1993) A retrospective analysis of pituitary apoplexy. Neurosurgery 33(4):602–608PubMedCrossRef
5.
Zurück zum Zitat Chang CZ, Wang CJ, Howng SL (1999) Pituitary adenomas in adolescence—ten year experience and literature review. Kaohsiung J Med Sci 15(12):691–696 (Aug)PubMed Chang CZ, Wang CJ, Howng SL (1999) Pituitary adenomas in adolescence—ten year experience and literature review. Kaohsiung J Med Sci 15(12):691–696 (Aug)PubMed
6.
Zurück zum Zitat Cola A, Loche S, Cappa M, Di Sarno A, Landi ML, Sarnacchiaro F, Facciolli G, Lombardi G (1998) Prolactinomas in children and adolescents Clinical presentation and long-term follow-up. J Clin Endocrinol Metab 83:2777–2780CrossRef Cola A, Loche S, Cappa M, Di Sarno A, Landi ML, Sarnacchiaro F, Facciolli G, Lombardi G (1998) Prolactinomas in children and adolescents Clinical presentation and long-term follow-up. J Clin Endocrinol Metab 83:2777–2780CrossRef
7.
Zurück zum Zitat Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68:860–866PubMedCrossRef Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68:860–866PubMedCrossRef
8.
Zurück zum Zitat De Menis E, Visentin A, Billeci D, Tramontin P, Agostini S, Marton E, Conte N (2001) Pituitary adenomas in childhood and adolescence. Clinical analysis of 10 cases. J Endocrinol Investig 24:92–97 De Menis E, Visentin A, Billeci D, Tramontin P, Agostini S, Marton E, Conte N (2001) Pituitary adenomas in childhood and adolescence. Clinical analysis of 10 cases. J Endocrinol Investig 24:92–97
9.
Zurück zum Zitat Dissaneevate P, Warne GL (1998) Hyperprolactinaemia and Pituitary adenomas in adolescence. J Pediatr Endocrinol Metab 11(4):531–541PubMed Dissaneevate P, Warne GL (1998) Hyperprolactinaemia and Pituitary adenomas in adolescence. J Pediatr Endocrinol Metab 11(4):531–541PubMed
10.
Zurück zum Zitat Dyer EH, Civit T, Visot A, Delalande O, Derome P (1994) Transsphenoidal surgery for pituitary adenomas in children. Neurosurgery 34:207–212PubMedCrossRef Dyer EH, Civit T, Visot A, Delalande O, Derome P (1994) Transsphenoidal surgery for pituitary adenomas in children. Neurosurgery 34:207–212PubMedCrossRef
11.
Zurück zum Zitat Farioli B, Ferrante L, Celli P (1983) Pituitary adenomas with onset during puberty, features and treatment. J Neurosurg 59:590–595 Farioli B, Ferrante L, Celli P (1983) Pituitary adenomas with onset during puberty, features and treatment. J Neurosurg 59:590–595
12.
Zurück zum Zitat Fisher BJ, Gaspar LE, Stitt LW, Noone BE (1994) Pituitary adenoma in adolescents: a biologically more aggressive disease? Radiology 192:869–872PubMed Fisher BJ, Gaspar LE, Stitt LW, Noone BE (1994) Pituitary adenoma in adolescents: a biologically more aggressive disease? Radiology 192:869–872PubMed
13.
Zurück zum Zitat Grigsby PW, Thomas PR, Simpson JR, Fineberg BB (1988) Long-term results of radiotherapy in the treatment of pituitary adenomas in children and adolescents. Am J Clin Oncol 11:607–611PubMedCrossRef Grigsby PW, Thomas PR, Simpson JR, Fineberg BB (1988) Long-term results of radiotherapy in the treatment of pituitary adenomas in children and adolescents. Am J Clin Oncol 11:607–611PubMedCrossRef
14.
Zurück zum Zitat Hadad SF, VanGilder JC, Menezes AH (1991) Pediatric pituitary tumors. Neurosurgery 29:509–514CrossRef Hadad SF, VanGilder JC, Menezes AH (1991) Pediatric pituitary tumors. Neurosurgery 29:509–514CrossRef
15.
Zurück zum Zitat Hoffman HJ (1982) Pituitary adenomas. In: American Association of Neurological Surgeons (eds) Pediatric neurosurgery: surgery of developing nervous system. Grune & Stratton, NY, pp 493–499 Hoffman HJ (1982) Pituitary adenomas. In: American Association of Neurological Surgeons (eds) Pediatric neurosurgery: surgery of developing nervous system. Grune & Stratton, NY, pp 493–499
16.
Zurück zum Zitat Knappe UJ, Luldecke DK (1996) Transnasal microsurgery in children and adolescents with Cushing’s disease. Neurosurgery 39:484–492PubMedCrossRef Knappe UJ, Luldecke DK (1996) Transnasal microsurgery in children and adolescents with Cushing’s disease. Neurosurgery 39:484–492PubMedCrossRef
17.
Zurück zum Zitat Knoepfelmacher M, Gomes MC, Melo ME, Mendonca BB (2004) Pituitary apoplexy during therapy with cabergoline in an adolescent male with prolactin-secreting macroadenoma. Pituitary 7(2):83–87PubMedCrossRef Knoepfelmacher M, Gomes MC, Melo ME, Mendonca BB (2004) Pituitary apoplexy during therapy with cabergoline in an adolescent male with prolactin-secreting macroadenoma. Pituitary 7(2):83–87PubMedCrossRef
18.
Zurück zum Zitat Knosp E, Kitz K, Perneczky A (1989) Proliferation activity in pituitary adenomas: measurement by monoclonal antibody Ki-67. Neurosurgery 25:927–930PubMedCrossRef Knosp E, Kitz K, Perneczky A (1989) Proliferation activity in pituitary adenomas: measurement by monoclonal antibody Ki-67. Neurosurgery 25:927–930PubMedCrossRef
19.
Zurück zum Zitat Kunwar S, Wilson CB (1999) Pediatric pituitary adenomas. J Clin Endocinol Metab 84:4385–4389CrossRef Kunwar S, Wilson CB (1999) Pediatric pituitary adenomas. J Clin Endocinol Metab 84:4385–4389CrossRef
20.
Zurück zum Zitat Landolt AM, Shibata T, Kleihues P (1987) Growth rate of human pituitary adenomas. J Neurosurg 67:803–806PubMed Landolt AM, Shibata T, Kleihues P (1987) Growth rate of human pituitary adenomas. J Neurosurg 67:803–806PubMed
21.
Zurück zum Zitat Laws ER, Scheithauer BW, Groover RV (1987) Pituitary adenomas in childhood and adolescence. Rog Exp Tumor Res 30:359–361 Laws ER, Scheithauer BW, Groover RV (1987) Pituitary adenomas in childhood and adolescence. Rog Exp Tumor Res 30:359–361
22.
Zurück zum Zitat Laws ER, Scheithauer BW, Groover RV (1994) Pituitary adenoma in adolescents: a biologically more aggressive disease. Radiology 92:869–872 Laws ER, Scheithauer BW, Groover RV (1994) Pituitary adenoma in adolescents: a biologically more aggressive disease. Radiology 92:869–872
23.
Zurück zum Zitat Lazaro CM, Guo WY, Sami M, Hindmarsh T, Ericson K, Hulting AL, Wersall J (1994) Hemorrhagic pituitary tumour. Neuroradiology 36:111–114PubMedCrossRef Lazaro CM, Guo WY, Sami M, Hindmarsh T, Ericson K, Hulting AL, Wersall J (1994) Hemorrhagic pituitary tumour. Neuroradiology 36:111–114PubMedCrossRef
24.
Zurück zum Zitat Maira G, Anile C (1990) Pituitary adenomas in childhood and adolescence. Can J Neurol Sci 17:83–87PubMed Maira G, Anile C (1990) Pituitary adenomas in childhood and adolescence. Can J Neurol Sci 17:83–87PubMed
25.
Zurück zum Zitat Martins AN, Hales M, Wilson CB (1981) Cerebellar metastasis from prolactinoma during treatment with bromocriptine. J Neurosurg 55:615–619 Martins AN, Hales M, Wilson CB (1981) Cerebellar metastasis from prolactinoma during treatment with bromocriptine. J Neurosurg 55:615–619
26.
27.
Zurück zum Zitat Mizutani T, Teramoto A, Aruga T, Takakura K, Sanno N (1993) Prepubescent pituitary null cell macro adenoma with silent macroscopic apoplexy: case report. Neurosurgery 33:907–910PubMedCrossRef Mizutani T, Teramoto A, Aruga T, Takakura K, Sanno N (1993) Prepubescent pituitary null cell macro adenoma with silent macroscopic apoplexy: case report. Neurosurgery 33:907–910PubMedCrossRef
28.
Zurück zum Zitat Nielsen EH, Lindholm J, Bjerre P, Christiansen JS, Hagen C, Juul S, Jorgensen J, Kruse A, Laurberg P (2006) Frequent occurrence of pituitary apoplexy in patients with non-functioning pituitary adenoma. Clin Endocrinol (Oxf) 64(3):319–322CrossRef Nielsen EH, Lindholm J, Bjerre P, Christiansen JS, Hagen C, Juul S, Jorgensen J, Kruse A, Laurberg P (2006) Frequent occurrence of pituitary apoplexy in patients with non-functioning pituitary adenoma. Clin Endocrinol (Oxf) 64(3):319–322CrossRef
29.
Zurück zum Zitat Nishio S, Morioka T, Suzuki S et al (2001) Pituitary tumours in adolescence. J Clin Neurosci 8(3):231–234PubMedCrossRef Nishio S, Morioka T, Suzuki S et al (2001) Pituitary tumours in adolescence. J Clin Neurosci 8(3):231–234PubMedCrossRef
30.
Zurück zum Zitat Ortiz-Suarez H, Erickson D (1975) Pituitary adenomas of adolescents. J Neurosurg 43:437–439PubMed Ortiz-Suarez H, Erickson D (1975) Pituitary adenomas of adolescents. J Neurosurg 43:437–439PubMed
31.
Zurück zum Zitat Partigton MD, Davis DH, Laws ER, Scheithauer BW (1994) Pituitary adenomas in childhood and adolescence: results of transsphenoidal surgery. J Neurosurg 80:209–216 Partigton MD, Davis DH, Laws ER, Scheithauer BW (1994) Pituitary adenomas in childhood and adolescence: results of transsphenoidal surgery. J Neurosurg 80:209–216
32.
Zurück zum Zitat Poussaint TY, Barnes PD, Anthony DC, Spack N, Scott RM, Tarbell NJ (1996) Hemorrhagic pituitary adenomas of adolescence. Am J Neuroradiol 17:1907–1912PubMed Poussaint TY, Barnes PD, Anthony DC, Spack N, Scott RM, Tarbell NJ (1996) Hemorrhagic pituitary adenomas of adolescence. Am J Neuroradiol 17:1907–1912PubMed
33.
Zurück zum Zitat Richmond IL, Wilson CB (1978) Pituitary adenomas in childhood and adolescence. J Neurosurg 49:163–168PubMedCrossRef Richmond IL, Wilson CB (1978) Pituitary adenomas in childhood and adolescence. J Neurosurg 49:163–168PubMedCrossRef
34.
Zurück zum Zitat Semple PL, Webb MK, de Villiers JC, Laws ER Jr (2005) Pituitary apoplexy. Neurosurgery 56(1):65–72PubMed Semple PL, Webb MK, de Villiers JC, Laws ER Jr (2005) Pituitary apoplexy. Neurosurgery 56(1):65–72PubMed
35.
Zurück zum Zitat Vance ML, Laws ER (2005) Role of medical therapy in the management of acromegaly. Neurosurgery 56(5):877–885PubMed Vance ML, Laws ER (2005) Role of medical therapy in the management of acromegaly. Neurosurgery 56(5):877–885PubMed
36.
Zurück zum Zitat Yousem DM, Arrington JA, Zinreich SJ, Kumar AJ, Bryan RN (1989) Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage. Radiology 170:239–243PubMed Yousem DM, Arrington JA, Zinreich SJ, Kumar AJ, Bryan RN (1989) Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage. Radiology 170:239–243PubMed
Metadaten
Titel
Pituitary tumors in children: clinical analysis of 21 cases
verfasst von
M. Mehrazin
Publikationsdatum
01.04.2007
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 4/2007
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-006-0259-4

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