Pediatric pituitary adenomas in Northeast Mexico. A follow-up study

Torres-García, Lucia; Cerda‐Flores, Ricardo M.; Márquez, Marcela

doi:10.1007/s12020-018-1687-0

Cited by 7 publications

(5 citation statements)

References 39 publications

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“…It has been reported that pituitary adenomas are more common in females, and female predominance has been reported to be as high as 3.3:1 in the young population [24]. In our cohort, there was a female predominance of 1.9:1, which is consistent with the literature.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies have shown that the most common pituitary adenomas in children are prolactinomas and corticotropinomas, and NFAs are extremely rare [3,15,16,24]. The articles reporting the highest percentages of NFA in the systematic review were Zhan et al [12] (26.8%), Giovinazzo et al…”

Section: Discussionmentioning

confidence: 96%

“…Due to their rarity and complexity, data on clinical, hormonal, and long-term follow-up of PPAs are limited, and most of the studies consist of surgical series [3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Few studies include non-surgical cases in the systematic review of the last 20 years [23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and therapeutic outcomes of pediatric pituitary adenomas: a single pituitary center experience

Kilci,

Jones,

Çaklılı

et al. 2023

Endocrine

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Pediatric pituitary adenomas (PPA) are rare. Although PPAs are mostly benign, they can be challenging to manage. Most studies evaluating PPA are based on surgical series. We aimed to present the clinical features, hormonal status and treatment outcomes of children with PPA managed in a joint neuroendocrine setting. MethodsIn this single-center study, demographic, clinical and endocrinological data of patients under 19 years old who were followed up with the diagnosis of PPA between 2002-2022 were retrospectively reviewed. A total of 21 studies published in the past 20 years were also systematically reviewed. ResultsThere were 79 patients (52 girls, 27 boys) with a median age of 15.8 years. Median follow-up time was 30 months. The most common adenoma subtype was non-functioning adenoma (NFA) (35.5%), followed by prolactinoma (29.1%), corticotropinoma (21.5%), and somatotropinoma (13.9%), respectively. The frequency of micro and macroadenomas was almost equal while 38% of all adenomas were invasive.Headache, visual impairment and menstrual irregularity were the most common complaints, while the most common hormonal de ciency at diagnosis was central hypothyroidism (31.6%), followed by hypogonadotropic hypogonadism (22.7%), growth hormone de ciency (15.2%) and central adrenal insu ciency (11.4%), respectively. Fifty patients (63.2%) underwent endoscopic endonasal transsphenoidal surgery (EETS). Following the surgery, impaired endocrine functions recovered at a rate of 62% while permanent central diabetes insipidus was observed in 6%, and new onset hypopituitarism developed in 4%. ConclusionNFA was more common in this cohort than in previous reports, which is one of the largest PPA series in the literature. Hormonal disorders, which were common at the time of diagnosis, were largely resolved with appropriate endocrinological and surgical approaches, while the rate of pituitary hormonal de ciencies after EETS was relatively low. Therefore, we recommend that children with PPA be managed in the setting of a high-volume pituitary centers to provide long-term low morbidity.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 96%

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Clinical and therapeutic outcomes of pediatric pituitary adenomas: a single pituitary center experience

Kilci,

Jones,

Çaklılı

et al. 2023

Endocrine

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“…[4] Pituitary adenomas (PA) are classified according to the 4th edition of the World Health Organization (WHO) 2017 guidelines by their immunohistochemical labelling, according to the somatotropic (GH), lactotropic (PRL), gonadotropic (FSH/LH), corticotropic (ACTH) or thyrotropic (TSH) contingent. [12,15].…”

Section: Discussionmentioning

confidence: 99%

Pituitary adenomas in children and adolescents: Diagnostic challenge

Rafi¹,

Ouakrim²,

Mghari³

et al. 2022

World J. Adv. Res. Rev.

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Pituitary adenomas have a low incidence in pediatric and adolescent patients, ant they are usually benign and relatively common intracranial tumors, with under- and overexpression of pituitary hormones and local mass effects causing considerable morbidity and increased mortality We report the observations of three patients who presented visual disorders, an MRI was done objectifying a sellar tumoral process with suspicion of a craniopharyngioma for the 3 cases, a surgical treatment was indicated with rectification of the diagnosis after the anatomopatho-immunohistochemical study, which concluded to a prolactinoma for 1st end 2nd cases which were put under dopamine agonists, and to a somatotropic adenoma for 3rd case which was addressed for revision surgery. Immunohistochemistry remains the key element in diagnosing pituitary tumors and orientating their management. The management of pituitary adenomas in pediatric patient’s mimic’s patterns of management in the adult population end requires a multidisciplinary management.

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“…Heterogeneity between groups: p = 0.022 Overall (I 2 = 71.34%, p = 0.00); Cannavò et al [36] Andereggen et al [30] Di Sarno et al [31] Tamasauskas et al [17] Babey et al [16] Vale et al [33] Barber et al [35] Andereggen et al [30] Micko et al [39] Medication Wolfsberger et al [41] Subtotal (I 2 = 74.35%, p = 0.00) Subtotal (I 2 = 7.88%, p = 0.37) Sala et al [34] Torres-García et al [38] Study Yi et al [18] Martin de Santa-Olalla y Llanes et al [32] Kreutzer et al [40] Andereggen et al [ Babey et al [16] Subtotal (I 2 = 77.49%, p = 0.00) Figure 4: Meta-analysis of remission rates comparing surgery and medical treatment in microprolactinomas after treatment withdrawal and the results of subgroup analysis: (a) the remission rate was achieved in 78% of patients treated with surgery and 44% of patients treated with DAs (P � 0.003) after treatment withdrawal and (b) the remission rate was achieved in 92% of patients with preoperative PRL level of ≤200 ng/ml and 40% of patients with preoperative PRL level of >200 ng/ml (P � 0.029).…”

Section: Discussionmentioning

confidence: 99%

Surgery and Medical Treatment in Microprolactinoma: A Systematic Review and Meta-Analysis

Cai

et al. 2021

International Journal of Endocrinology

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Objective. Dopamine agonists (DAs) are recommended as the first-line treatment for prolactinomas; however, tumour recurrence after drug withdrawal remains a clinical problem. Recent studies have reported high remission rates via surgery in microprolactinomas. The aim of this systematic review and meta-analysis was to compare the clinical result of DA treatment with surgery as initial therapy in patients with treatment-naive microprolactinoma. Methods. A comprehensive literature search for studies and reports regarding microprolactinoma patients treated with DAs and/or surgery published between January 1970 and November 2020 was conducted using four electronic databases (PubMed, Embase, Google Scholar, and the Cochrane Library). Clinical treatment outcome was evaluated by the biochemical remission of serum prolactin level to normal after treatment. The I2 statistic was used to quantify heterogeneity. Pooled data were analysed according to a random effect model. Results. Eighteen studies with 661 patients were included for analysis. The DA treatment group achieved a higher remission rate at ≥12 months follow-up (96% vs. 86%; P = 0.019 ). Surgery showed a higher remission rate than the DA treatment group after the treatment withdrawal (78% vs. 44%; P = 0.003 ). Patients with preoperative prolactin level of ≤200 ng/mL had a higher remission rate than patients with preoperative prolactin level of >200 ng/mL (92% vs. 40%; P = 0.029 ). Conclusion. Surgery showed a high remission rate in treatment-naive microprolactinoma patients after treatment withdrawal and may be an alternative first-line treatment strategy in addition to DAs, particularly in patients with a preoperative prolactin level of ≤200 ng/mL.

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Pediatric pituitary adenomas in Northeast Mexico. A follow-up study

Cited by 7 publications

References 39 publications

Clinical and therapeutic outcomes of pediatric pituitary adenomas: a single pituitary center experience

Clinical and therapeutic outcomes of pediatric pituitary adenomas: a single pituitary center experience

Pituitary adenomas in children and adolescents: Diagnostic challenge

Surgery and Medical Treatment in Microprolactinoma: A Systematic Review and Meta-Analysis

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