Pituitary tumors in children: clinical analysis of 21 cases

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