Pituitary microadenoma in children and adolescents: Minireview of literature and symptomatic case series
1 Department of Pediatric Division of Endocrinology, Hamad General Hospital, Doha, Qatar.
2 Pediatric and Adolescent Outpatient Clinic, Private Accredited Quisisana Hospital, Ferrara, Italy.
Review Article
World Journal of Advanced Research and Reviews, 2024, 21(02), 472–480
Article DOI: 10.30574/wjarr.2024.21.2.0452
Publication history:
Received on 26 December 2023; revised on 03 February 2024; accepted on 06 February 2024
Abstract:
Pituitary microadenomas in children and adolescents represent a rare yet clinically significant entity, with a prevalence of up to 1 per million children and constituting only a small fraction of pediatric intracranial neoplasms. This minireview synthesizes current literature to provide an insightful overview of the epidemiology, clinical presentation, management, and outcomes of these tumors. Pituitary microadenomas are categorized as either functioning or nonfunctioning, with the former being less common in children than adults. Functioning microadenomas, such as prolactinomas, growth hormone-secreting adenomas, and ACTH-secreting adenomas, present with symptoms linked to hormonal overproduction, while nonfunctioning adenomas are often asymptomatic.
Clinical presentations vary with tumor type, with common symptoms including amenorrhea, galactorrhea, gynecomastia, and headaches. Diagnosis relies heavily on hormonal assessments and MRI, with stable courses often observed in non-functioning microadenomas. We report 6 cases which were presented with variable endocrine abnormalities. Management strategies are tailored based on the tumor’s functionality and size. Medical therapy, primarily dopamine agonists, is preferred for functioning adenomas, while transsphenoidal surgery is reserved for symptomatic or non-responsive cases. Radiotherapy is considered as a third-line option.
Outcomes are generally favorable, with high response rates to medical therapy and successful surgical resections. However, recurrence and long-term hormonal imbalances pose challenges, necessitating vigilant long-term follow-up. Current research is oriented towards enhancing diagnostic accuracy, understanding genetic contributions, and optimizing treatment to minimize long-term developmental impacts. This review underscores the necessity for a nuanced approach in the diagnosis and management of pediatric pituitary microadenomas, highlighting the importance of ongoing research and follow-up for optimal patient care.
Keywords:
Pituitary; Microadenoma; Children; Adolescents; Presentation; Diagnosis; Management.
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