Pituitary Tumors in Pediatric Patients

Abstract

Although pediatric pituitary and parasellar tumors are uncommon, they can produce significant disability and pose significant treatment challenges for pediatricians, endocrinologists, and neurosurgeons. Despite their rarity in pediatric patients, there are a wide range of lesions that affect the pituitary gland and parasellar region. Craniopharyngioma is the most common, followed by hormone-active pituitary tumors. Fortunately, most pituitary tumors in children are benign. However, given the location of these tumors, they can have a profound impact on hormonal regulation in growing children. Therefore, surgical interventions must be planned carefully in order to minimize operative morbidity and maximize functional recovery. As with adult pituitary lesions, the transsphenoidal corridor often is a surgical option for treating pituitary and parasellar tumors in children. In this chapter we discuss some of the surgical nuances of transsphenoidal surgery in pediatric patients. We then review the clinical presentation, operative considerations, and surgical outcomes for the most common pediatric pituitary tumors. Finally, we discuss complication avoidance and management.