Clinical manifestations and treatment of pediatric pituitary adenoma / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the clinical manifestations and treatment of pediatric pituitary adenoma.Methods Between January 2001 to January 2015,24 pediatric patients diagnosed with pituitary.adenoma were treated in People's Hospital of Henan Province.The clinical data were retrospectively analyzed,including age,gender,clinical manifestation,therapy and prognosis.Endocrinological levels including all pituitrin and magnetic resonance imaging were analyzed by the follow-up survey.Results The median age was 16.2 years old,ranged from 6.0 to 17.8 years old.Common clinical manifestations were comprised of endocrine-related symptoms (18 cases) and visual deficit (8 cases),and so on.The ratio of male to female was 1.∶ 3.There were 12 cases of prolactin (PRL)-secreting adenoma (50.0％),4 cases of adrenocorticotropic hormone-secreting adenoma (16.7％),3 cases of growth hormone-secreting adenoma (12.5％),3 cases of plurihorminal adenomas (12.5％),and 2 cases of non-functioningadenomas (8.4％).The ratio of micro-adenoma versus macro-adenoma was 15.∶ 9,and there was no invasive macro-adenoma.Transsphenoidal surgery was applied in 14 cases (58.3 ％) with respect to 2 cases (8.3 ％) in transorbital keyhole approach,5 cases (20.8％) through pterional approach,and still 1 case (4.2％) through transsubfrontal approach.Two cases(8.3％) were cured with medications.Eighteen cases were totally resected,while 4 cases were subtotal resected.Six of 18 gross total resection patients recurred within 2 years,while tumors of subtotal resection grew differently.Hypotrophy in patients who received Gamma knife therapy (4/7 cases) was statistically different than that in the patients who did not (7/17 cases) (P =0.002).Conclusion Pediatric pituitary adenomas are usually common in female with endocrine related symptoms,and PRL-secreting adenoma is the most common subtype,and recurrence rate was higher.Individualized therapy is needed for the invalid cases.But any radiotherapy including Gamma knife therapy might induce hypotrophy,which requires special attention.