Clinical Course of Hyperprolactinemia in Children and Adolescents: A Review of 21 Cases - Original Article

Eren, Erdal; Yapıcı, Şenay; Çakır, Esra Deniz Papatya; Ceylan, Latife Aytekin; Sağlam, Halil; Tarım, Ömer

doi:10.4274/jcrpe.v3i2.14

Cited by 34 publications

(12 citation statements)

References 24 publications

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“…In spite of the feasibility of gross total resection, recurrence rate is higher in pediatric populations [25,26,27]. We have 3 cases of subtotal resection in our series.…”

Section: Discussionmentioning

confidence: 90%

Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas

Taşkapılıoğlu¹,

Yılmazlar²,

Eren

et al. 2015

Pediatr Neurosurg

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Aim: To evaluate the clinical outcome in a 13-year consecutive series of children operated for pituitary adenomas with transnasal transsphenoidal surgery. Methods: All patients <18 years who were operated on at our center by transsphenoidal surgery for pediatric pituitary adenomas were included in the study. Clinical features, hormonal profile, radiology, surgical approach, results and complications were analyzed. Results: Eighteen patients (90%) had functional pituitary adenomas and 2 (10%) patients had nonfunctional pituitary adenoma. The most common type was prolactin-secreting adenoma (n = 12), followed by corticotropinoma (n = 4), growth hormone-secreting adenoma (n = 2), and nonfunctioning adenoma (n = 2). Prolactin-secreting adenomas in children occurred more commonly with suprasellar expansion than did other adenomas. Conclusion: Transsphenoidal surgery was effective for decompression of suprasellar extension and relieved the chiasmal compression immediately. Prolactin-secreting tumors required postoperative medical therapy for persistently elevated prolactin levels.

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“…In spite of the feasibility of gross total resection, recurrence rate is higher in pediatric populations [25,26,27]. We have 3 cases of subtotal resection in our series.…”

Section: Discussionmentioning

confidence: 90%

Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas

Taşkapılıoğlu¹,

Yılmazlar²,

Eren

et al. 2015

Pediatr Neurosurg

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“…Girls are more affected than boys, with a ratio varying from 1.9:1 to 4.5:1 depending on age. In boys the tumours are usually large and aggressive [1,34,35]. …”

Section: Individual Adenomasmentioning

confidence: 99%

Paediatric Pituitary Adenomas: A Decade of Change

et al. 2014

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Pituitary adenomas, although rare in the paediatric age range and mostly benign, represent very challenging disorders for diagnosis and management. The recent identification of genetic alterations in young individuals with pituitary adenomas has broadened the scope of molecular investigations and contributed to the understanding of mechanisms of tumorigenesis. Recent identification of causative mutations of genes such as GNAS, PRKAR1A, MEN1 and AIP has introduced the concept of molecular screening of young apparently healthy family members. Population-based studies have reported a significantly higher number of affected subjects and genetic variations than expected. Radiological techniques have advanced, yet many microadenomas remain undetectable on scanning. However, experience with transsphenoidal and endoscopic pituitary surgery has led to higher rates of cure. Prolactinomas, corticotroph and somatotroph adenomas remain the most prevalent, with each diagnosis presenting its own challenges. As paediatric pituitary adenomas occur very infrequently within the paediatric age range, paediatric endocrine units cannot provide expert management in isolation. Consequently, close co-operation with adult endocrinology colleagues with experience of pituitary disease is strongly recommended.

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“…For example, in a study conducted at 3 French tertiary reference centers over a period of 30 years, only 77 patients younger than 20 years were diagnosed with prolactinomas, and only 2 of these cases reported were in patients younger than 10 years (the patients were 4.5 and 10 years old) [11]. Other studies on prolactinomas in children report the same low frequency: one 10-year-old patient in 41 children [8], one 7.4-year-old patient among 21 observed cases [13], and one 7-year-old patient among 26 diagnosed cases [12]. …”

Section: Discussionmentioning

confidence: 79%

“…Another peculiar characteristic of our case was the resistance to both bromocriptine and cabergoline, as most prolactinoma patients in childhood and adolescence [13, 14, 18, 20] and adulthood [2, 24] respond to treatment with these DAs. Resistance to bromocriptine is defined as the absence of normalization in prolactin levels when patients are treated with the maximum tolerable dose or with 15 mg daily [25, 26].…”

Section: Discussionmentioning

confidence: 99%

“…Another study reported poor surgical outcome and a recurrence rate of 67% in children with prolactinoma [39]. Surgery may also require complementation with cabergoline treatment or radiotherapy [13, 40]. However, an important observation was that patients that underwent surgery for the partial removal of the tumor had an improved response to DAs [23].…”

Section: Discussionmentioning

confidence: 99%

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Beneficial Effects of High Doses of Cabergoline in the Treatment of Giant Prolactinoma Resistant to Dopamine Agonists: A Case Report with a 21-Year Follow-Up

Castro¹,

Gonzaga²,

Naves³

et al. 2017

Horm Res Paediatr

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Introduction: Prolactinomas are pituitary tumors with a very low prevalence in childhood and adolescence compared to adulthood. This condition is preferentially treated with dopamine agonists. Resistance to these drugs is rare. Case Report: We describe the case of a boy diagnosed with macroadenoma at the age of 9 and followed up for 21 years. He did not fully respond to treatment with dopamine agonists. His initial prolactin level was 2,400 ng/mL (in males, normal values are <16.0 ng/mL) and never normalized. At the last assessment, his prolactin level was 21.5 ng/mL, recorded after 21 years of treatment with the dopamine agonist cabergoline at a dose as high as 4.5 mg per week. Although the prolactin level remained elevated throughout the follow-up period, the patient never presented a low testosterone level and had normal pubertal development. An MRI of the sella turcica showed that the tumor became progressively cystic and disappeared, but a normal pituitary gland was observed. The pituitary gland retained its normal functions despite a partially empty sella. Discussion: Long-term treatment with high doses of cabergoline may cause cystic degeneration of a prolactinoma considered to be resistant to this treatment, but we cannot rule out the possibility that this outcome represents the natural development of the tumor.

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Clinical Course of Hyperprolactinemia in Children and Adolescents: A Review of 21 Cases - Original Article

Cited by 34 publications

References 24 publications

Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas

Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas

Paediatric Pituitary Adenomas: A Decade of Change

Beneficial Effects of High Doses of Cabergoline in the Treatment of Giant Prolactinoma Resistant to Dopamine Agonists: A Case Report with a 21-Year Follow-Up

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