Comparative analysis of pituitary adenoma with and without apoplexy in pediatric and adolescent patients: a clinical series of 80 patients.

Run Wang,Longjie Li,Zixun Wang,Sheng Han,Xiaodi Han,Yifu Song

doi:10.1007/s10143-021-01551-z

Run Wang, Longjie Li + Show 4 more

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https://doi.org/10.1007/s10143-021-01551-z

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Abstract

Pituitary adenomas (PAs) have a low incidence in pediatric and adolescent patients, and their clinical characteristics remain unclear. As a severe complication of PA, apoplexy was investigated in young patients in the present study. Eighty patients younger than 20years with PAs who underwent surgery were included and divided into an apoplexy group and non-apoplexy group. The clinical data of these two groups were statistically analyzed and compared. The study included 33 boys and 47 girls, with a mean age of 16.9years. There were six (7.5%) adrenocorticotropic hormone-secreting, 13 (16.3%) growth hormone-secreting, 47 (58.7%) prolactin-secreting, and 14 (17.5%) non-functioning PAs. There were 34 (42.5%) patients in the apoplexy group and 46 (57.5%) patients in the non-apoplexy group. Pre-operatively, patients in the apoplexy group were more likely to have visual impairment (hazard ratio: 2.841, 95% confidence interval: 1.073-7.519; P = 0.033) and had poorer visual impairment scores than those in the non-apoplexy group (P = 0.027). Furthermore, a longer duration of symptoms before surgery was significantly correlated with a poorer visual outcome in the apoplexy group (R = - 1.204; P = 0.035). However, apoplexy was not associated with tumor type, tumor size, resection rate, or tumor recurrence. Tumor apoplexy is common in pediatric and adolescent patients with PAs and is associated with more severe preoperative visual deficits. Hence, the appropriate timing of surgical treatment may be important for rescuing visual function in young PA patients.

Highlights

Pituitary adenoma (PA) is the third most common intracranial tumor in adults, its incidence in pediatric and adolescent patients is low, accounting for approximately 2.6– 6.1% of all pituitary tumor [5, 16] and 1% of all intracranial tumors [30] in pediatric and adolescent patients
Appropriate surgical treatment may be important for salvaging visual function in young Pituitary adenomas (PAs) patients
None of the pediatric and adolescent patients in the present study had any of the above histories or clinical features

Summary

Introduction

Pituitary adenoma (PA) is the third most common intracranial tumor in adults, its incidence in pediatric and adolescent patients (under the age of 20 years) is low, accounting for approximately 2.6– 6.1% of all pituitary tumor [5, 16] and 1% of all intracranial tumors [30] in pediatric and adolescent patients. Apoplexy is a major complication of pituitary tumors and may result in sudden headaches, visual deficits, vomiting, and other symptoms [13]. The specific clinical features of pituitary adenoma apoplexy (PAA) remain unclear in pediatric and adolescent patients due to the small number of reported cases. Conflicting results have been found in the literature concerning the clinical and prognostic implications of PAA in young patients [15, 33]. We analyzed clinical data from 80 pediatric and adolescent patients with PAs. In the present study, we analyzed clinical data from 80 pediatric and adolescent patients with PAs We divided these patients into an apoplexy group and non-apoplexy group and compared their clinical characteristics

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