Pituitary Tumors in Childhood and Adolescence

Kim, Joo Han; Park, Jung Yul; Chung, Yong Gu; Jung, Hung Seob; Lee, Ki Chan; Lee, Hoon Kap

Abstract

Pituitary adenomas are uncommon in childhood and adolescence. From a series of 94 patients with pituitary adenoma operated by microsurgical technique during the period of June. 1988 to March, 1994, the cases of nine young people whose symptoms had appeared between the ages of 8.3 and 17.3 years are selected and presented. Of these 9 patients, three(33.3%) had prolactin(PRL)-secreting tumors. 3(33.3%) had PRL and adrenocorticotropic hormone(ACTH)-secreting tumors, and among remaining three patients had a tumor secreting both growth hormone(GH) and PRL, one with clinically nonfunctioning tumor, and one with a craniopharyngioma. The average age of patients at the time of surgery was 14.8 years with the youngest patient being 8.5 years old. Presenting symptoms primarily reflected the increased intracranial pressure. All but one underwent operations by the transsphenoidal approach(TSA). There was no death in this patient group. Significant operative morbidity included one incidence of third nerve palsy in one case after transcranial approach and diabetes insipidus in another after TSA. Both incidences were transient and were resolved later. Plurihormonal tumors, broadly defined as tumors producing more than one hormone, were common in this study group. Follow-up study revealed good control of tumors in the majority of cases, however there were two cases of recurrences on 80% of initial remission rate. Based on the observed data, it is concluded that: 1) transsphenoidal surgery is feasible and safe in this age group: 2) plurihormonal tumors occur more frequently in the pediatric and adolescent age group than in adults: 3) Suprasellar extension is more frequent in this age group that in adults: 4) initial remission is high, but recurrence rate seems to be higher in this age group than in adults.