Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Faculty of Medicine of University of Porto, Porto, Portugal.
Pituitary. 2019 Apr;22(2):124-128. doi: 10.1007/s11102-019-00940-4.
Guidelines on pituitary incidentalomas evaluation and management are limited to adults since there are no data on this matter in the paediatric population. We aim to analyse the morphologic characteristics, hormonal profile and follow-up of these lesions in children.
We have searched for pituitary incidentalomas in the neuroimaging reports and electronic medical records of the Paediatric Endocrinology Clinic of our centre. Patients with 18 years-old or less were included.
Forty-one incidentalomas were identified, 25 of them (62.4%) in females. The mean age at diagnosis was 12.0 ± 4.96 years-old. Headaches were the main reason that led to image acquisition (51.2%) and MRI was the imaging method that detected the majority of the incidentalomas (70.7%). The most prevalent lesion was pituitary hypertrophy (29.3%), which was mainly diagnosed in female adolescents (91.7%), followed by arachnoid cysts (17.1%), pituitary adenomas (14.6%) and Rathke's cleft cysts (12.2%). Most patients (90.2%) did not present clinical or laboratorial findings of hypopituitarism or hormonal hypersecretion. Four patients presented endocrine dysfunction: three had growth hormone deficiency and one had a central precocious puberty. Twenty-three patients (56.1%) underwent imagiological revaluation during a median follow-up time of 24.6 months (interquartile range 5.07). None of them presented dimensional progression.
To the best of our knowledge, this is the first series of pituitary incidentalomas in pediatric age. Comparing our series with those conducted in adults, we have observed a higher preponderance of pituitary hypertrophy over adenomas, a lower prevalence of hormonal hyper/hyposecretion and lower risk of dimensional progression during follow-up.
关于垂体意外瘤评估和管理的指南仅限于成年人，因为在儿科人群中没有关于这方面的数据。我们旨在分析这些病变的形态特征、激素谱和随访情况。
我们在中心儿科内分泌科的神经影像学报告和电子病历中搜索垂体意外瘤。纳入年龄在 18 岁以下的患者。
共发现 41 例意外瘤，其中 25 例（62.4%）为女性。诊断时的平均年龄为 12.0±4.96 岁。头痛是导致图像采集的主要原因（51.2%），而 MRI 是检测大多数意外瘤的影像学方法（70.7%）。最常见的病变是垂体肥大（29.3%），主要发生在女性青少年（91.7%），其次是蛛网膜囊肿（17.1%）、垂体腺瘤（14.6%）和 Rathke 氏裂囊肿（12.2%）。大多数患者（90.2%）没有出现垂体功能减退或激素分泌过多的临床或实验室发现。有 4 例患者出现内分泌功能障碍：3 例生长激素缺乏，1 例中枢性性早熟。23 例患者（56.1%）在中位随访 24.6 个月（四分位距 5.07）期间进行了影像学复查。他们中没有一个人的尺寸出现进展。
据我们所知，这是儿科年龄组中首例垂体意外瘤系列报道。与成人系列相比，我们观察到垂体肥大的发生率高于腺瘤，激素高/低分泌的发生率较低，随访期间尺寸进展的风险较低。
