Child's Nervous System

, Volume 23, Issue 4, pp 391–398 | Cite as

Pituitary tumors in children: clinical analysis of 21 cases

  • M. Mehrazin
Original Paper



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.


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.


Children Pituitary adenomas Clinical analysis Pituitary apoplexy 



I thank Dr. Babak Ghassemi for his comments and editing.


  1. 1.
    Abe T, Tara LA, Ludecke DK (1999) Growth hormone-secreting pituitary adenomas in childhood and adolescence: features and results of transnasal surgery. Neurosurgery 45:1–10PubMedCrossRefGoogle Scholar
  2. 2.
    Abe T, Ludecke DK, Saeger W (1998) Clinically nonsecreting pituitary adenomas in childhood and adolescence. Neurosurgery 42:744–750PubMedCrossRefGoogle Scholar
  3. 3.
    Artese R, D’Oslavalo DH, Mollocznik I et al (1998) Pituitary tumors in adolescent patients. Neurol Res 20:415–417PubMedGoogle Scholar
  4. 4.
    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):602–608PubMedCrossRefGoogle Scholar
  5. 5.
    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)PubMedGoogle Scholar
  6. 6.
    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 83:2777–2780CrossRefGoogle Scholar
  7. 7.
    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 68:860–866PubMedCrossRefGoogle Scholar
  8. 8.
    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 24:92–97Google Scholar
  9. 9.
    Dissaneevate P, Warne GL (1998) Hyperprolactinaemia and Pituitary adenomas in adolescence. J Pediatr Endocrinol Metab 11(4):531–541PubMedGoogle Scholar
  10. 10.
    Dyer EH, Civit T, Visot A, Delalande O, Derome P (1994) Transsphenoidal surgery for pituitary adenomas in children. Neurosurgery 34:207–212PubMedCrossRefGoogle Scholar
  11. 11.
    Farioli B, Ferrante L, Celli P (1983) Pituitary adenomas with onset during puberty, features and treatment. J Neurosurg 59:590–595Google Scholar
  12. 12.
    Fisher BJ, Gaspar LE, Stitt LW, Noone BE (1994) Pituitary adenoma in adolescents: a biologically more aggressive disease? Radiology 192:869–872PubMedGoogle Scholar
  13. 13.
    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 11:607–611PubMedCrossRefGoogle Scholar
  14. 14.
    Hadad SF, VanGilder JC, Menezes AH (1991) Pediatric pituitary tumors. Neurosurgery 29:509–514CrossRefGoogle Scholar
  15. 15.
    Hoffman HJ (1982) Pituitary adenomas. In: American Association of Neurological Surgeons (eds) Pediatric neurosurgery: surgery of developing nervous system. Grune & Stratton, NY, pp 493–499Google Scholar
  16. 16.
    Knappe UJ, Luldecke DK (1996) Transnasal microsurgery in children and adolescents with Cushing’s disease. Neurosurgery 39:484–492PubMedCrossRefGoogle Scholar
  17. 17.
    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):83–87PubMedCrossRefGoogle Scholar
  18. 18.
    Knosp E, Kitz K, Perneczky A (1989) Proliferation activity in pituitary adenomas: measurement by monoclonal antibody Ki-67. Neurosurgery 25:927–930PubMedCrossRefGoogle Scholar
  19. 19.
    Kunwar S, Wilson CB (1999) Pediatric pituitary adenomas. J Clin Endocinol Metab 84:4385–4389CrossRefGoogle Scholar
  20. 20.
    Landolt AM, Shibata T, Kleihues P (1987) Growth rate of human pituitary adenomas. J Neurosurg 67:803–806PubMedGoogle Scholar
  21. 21.
    Laws ER, Scheithauer BW, Groover RV (1987) Pituitary adenomas in childhood and adolescence. Rog Exp Tumor Res 30:359–361Google Scholar
  22. 22.
    Laws ER, Scheithauer BW, Groover RV (1994) Pituitary adenoma in adolescents: a biologically more aggressive disease. Radiology 92:869–872Google Scholar
  23. 23.
    Lazaro CM, Guo WY, Sami M, Hindmarsh T, Ericson K, Hulting AL, Wersall J (1994) Hemorrhagic pituitary tumour. Neuroradiology 36:111–114PubMedCrossRefGoogle Scholar
  24. 24.
    Maira G, Anile C (1990) Pituitary adenomas in childhood and adolescence. Can J Neurol Sci 17:83–87PubMedGoogle Scholar
  25. 25.
    Martins AN, Hales M, Wilson CB (1981) Cerebellar metastasis from prolactinoma during treatment with bromocriptine. J Neurosurg 55:615–619Google Scholar
  26. 26.
    Mindermann T, Wilon CB (1995) Pediatric pituitary adenomas. Neurosurgery 36:259–268PubMedCrossRefGoogle Scholar
  27. 27.
    Mizutani T, Teramoto A, Aruga T, Takakura K, Sanno N (1993) Prepubescent pituitary null cell macro adenoma with silent macroscopic apoplexy: case report. Neurosurgery 33:907–910PubMedCrossRefGoogle Scholar
  28. 28.
    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):319–322CrossRefGoogle Scholar
  29. 29.
    Nishio S, Morioka T, Suzuki S et al (2001) Pituitary tumours in adolescence. J Clin Neurosci 8(3):231–234PubMedCrossRefGoogle Scholar
  30. 30.
    Ortiz-Suarez H, Erickson D (1975) Pituitary adenomas of adolescents. J Neurosurg 43:437–439PubMedGoogle Scholar
  31. 31.
    Partigton MD, Davis DH, Laws ER, Scheithauer BW (1994) Pituitary adenomas in childhood and adolescence: results of transsphenoidal surgery. J Neurosurg 80:209–216Google Scholar
  32. 32.
    Poussaint TY, Barnes PD, Anthony DC, Spack N, Scott RM, Tarbell NJ (1996) Hemorrhagic pituitary adenomas of adolescence. Am J Neuroradiol 17:1907–1912PubMedGoogle Scholar
  33. 33.
    Richmond IL, Wilson CB (1978) Pituitary adenomas in childhood and adolescence. J Neurosurg 49:163–168PubMedCrossRefGoogle Scholar
  34. 34.
    Semple PL, Webb MK, de Villiers JC, Laws ER Jr (2005) Pituitary apoplexy. Neurosurgery 56(1):65–72PubMedGoogle Scholar
  35. 35.
    Vance ML, Laws ER (2005) Role of medical therapy in the management of acromegaly. Neurosurgery 56(5):877–885PubMedGoogle Scholar
  36. 36.
    Yousem DM, Arrington JA, Zinreich SJ, Kumar AJ, Bryan RN (1989) Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage. Radiology 170:239–243PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Neurological Surgery, Dr. Shariati HospitalTehran University of Medical SciencesTehranIran

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