Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China.
Neurosurg Rev. 2022 Feb;45(1):491-498. doi: 10.1007/s10143-021-01551-z. Epub 2021 Apr 29.
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 20 years 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 16.9 years. 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.
垂体腺瘤 (PAs) 在儿科和青少年患者中的发病率较低，其临床特征尚不清楚。本研究探讨了 PA 年轻患者的一种严重并发症——卒中。本研究纳入了 80 例接受手术治疗的年龄小于 20 岁的 PA 患者，并将其分为卒中组和非卒中组。对两组患者的临床资料进行统计学分析和比较。研究共纳入 33 例男性和 47 例女性患者，平均年龄为 16.9 岁。其中 6 例（7.5%）为促肾上腺皮质激素分泌型，13 例（16.3%）为生长激素分泌型，47 例（58.7%）为催乳素分泌型，14 例（17.5%）为无功能型 PA。卒中组 34 例，非卒中组 46 例。术前，卒中组患者更易出现视力障碍（风险比：2.841，95%置信区间：1.073-7.519；P=0.033），且视力障碍评分较非卒中组差（P=0.027）。此外，术前症状持续时间与卒中组患者的视力预后较差呈显著负相关（R=-1.204；P=0.035）。然而，卒中与肿瘤类型、肿瘤大小、切除率或肿瘤复发无关。垂体腺瘤卒中在儿科和青少年患者中较为常见，且与术前更严重的视力障碍相关。因此，对于年轻 PA 患者，手术治疗的时机可能对挽救视力功能非常重要。
