Kocabey Sütçü Zümrüt, Aytaç Kaplan Emel Hatun, Erkan Buruç, Önal Hasan
¹Department of Pediatric Endocrinology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
²Department of Neurosurgery, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
Pituitary. 2025 Sep 22;28(5):101. doi: 10.1007/s11102-025-01572-7.
To evaluate the clinical characteristics, surgical outcomes, and endocrinological follow-up findings of pediatric patients who underwent surgical treatment for sellar and parasellar masses.
Forty-seven patients who underwent surgical treatment for sellar and parasellar masses between January 2021 and January 2025 were retrospectively analyzed. All patients were followed up in the pediatric endocrinology clinic. Demographic characteristics, clinical findings, surgical approaches, histopathological diagnoses, and postoperative outcomes were evaluated. Endocrinological assessments were performed using standardized hormone assays with age- and sex-specific reference ranges.
Twenty-eight (59.6%) patients were female, with a median age of 10.1 years (range: 2.5-17.5). The most common presenting complaint was headache (46.8%), followed by visual impairment (27.7%) and short stature (14.9%). Histopathological examination revealed non-pituitary masses in 35 (74.5%) patients, with craniopharyngioma being the most frequent (44.7%). An endoscopic approach was used in 42 (89.4%) patients, and total resection was achieved in 30 (63.8%) patients. Panhypopituitarism developed in 27 (57.4%) patients postoperatively, representing a significant increase from preoperative rates (10.6%, p < 0.001). During a median follow-up of 2.5 years, recurrence occurred in 10 (21.3%) patients and mortality in 11 (23.4%) patients. Patients with non-pituitary tumors had significantly higher rates of re-operation (37.1% vs. 0%, p = 0.012) and mortality (31.4% vs. 0%, p = 0.024) compared to those with pituitary tumors.
Surgical management of pediatric sellar and parasellar masses carries significant risk of endocrinological complications, particularly panhypopituitarism. A multidisciplinary approach combining appropriate surgical technique selection, comprehensive endocrinological evaluation, and long-term follow-up is essential for optimal patient outcomes. Non-pituitary masses, especially craniopharyngioma, are associated with higher morbidity and mortality rates.
评估接受鞍区和鞍旁肿物手术治疗的儿科患者的临床特征、手术结果及内分泌随访结果。
回顾性分析2021年1月至2025年1月间接受鞍区和鞍旁肿物手术治疗的47例患者。所有患者均在儿科内分泌门诊进行随访。评估人口统计学特征、临床表现、手术方式、组织病理学诊断及术后结果。使用具有年龄和性别特异性参考范围的标准化激素检测进行内分泌评估。
28例（59.6%）患者为女性，中位年龄10.1岁（范围：2.5 - 17.5岁）。最常见的主诉是头痛（46.8%），其次是视力障碍（27.7%）和身材矮小（14.9%）。组织病理学检查显示35例（74.5%）患者为非垂体肿物，其中颅咽管瘤最为常见（44.7%）。42例（89.4%）患者采用了内镜手术方式，30例（63.8%）患者实现了全切。术后27例（57.4%）患者发生垂体功能减退，较术前发生率显著增加（10.6%，p < 0.001）。中位随访2.5年期间，10例（21.3%）患者复发，11例（23.4%）患者死亡。与垂体肿瘤患者相比，非垂体肿瘤患者的再次手术率（37.1%对0%，p = 0.012）和死亡率（31.4%对0%，p = 0.024）显著更高。
儿科鞍区和鞍旁肿物的手术治疗存在显著的内分泌并发症风险，尤其是垂体功能减退。采用多学科方法，结合合适的手术技术选择、全面的内分泌评估和长期随访，对于实现最佳患者预后至关重要。非垂体肿物，尤其是颅咽管瘤，与更高的发病率和死亡率相关。
