Colao Annamaria, Loche Sandro
Endocr Dev. 2010;17:146-159. doi: 10.1159/000262536. Epub 2009 Nov 24.
Prolactinomas are the most common pituitary adenomas in children and adolescents followed by adrenocorticotropic hormone-secreting and growth hormone-secreting adenomas. Females are slightly more affected than males (who have macroadenomas more frequently). Compared with the adult setting, in children macroadenomas are more frequent than microadenomas. Diagnosis is generally based on clinical symptoms of primary or secondary gonadal failure, growth delay and/or tumor compressive symptoms. Treatment is based on medical therapy with dopamine agonists, to control prolactin levels and reduce tumor size. Surgery is indicated in patients with tumors resistant to dopamine agonists as well as in those showing severe neurological symptoms at diagnosis. Radiotherapy should be limited to the cases with aggressive tumors, nonresponsive to dopamine agonists, because of the risk of neurological damage and hypopituitarism later in the lives of these patients.
泌乳素瘤是儿童和青少年中最常见的垂体腺瘤，其次是促肾上腺皮质激素分泌型和生长激素分泌型腺瘤。女性比男性受影响略多（男性更常发生大腺瘤）。与成人情况相比，儿童中大腺瘤比微腺瘤更常见。诊断通常基于原发性或继发性性腺功能减退、生长发育迟缓及/或肿瘤压迫症状的临床症状。治疗基于使用多巴胺激动剂的药物治疗，以控制泌乳素水平并缩小肿瘤大小。对于对多巴胺激动剂耐药的肿瘤患者以及诊断时出现严重神经症状的患者，建议进行手术。放疗应仅限于对多巴胺激动剂无反应的侵袭性肿瘤病例，因为这些患者后期有神经损伤和垂体功能减退的风险。
