Pituitary Adenomas in Pediatric Patients: Are They more Invasive?

Sl, Kanter; Jp, Mickle; Sb, Hunter; Al, Rhoton

doi:10.1159/000120251

Cited by 16 publications

(9 citation statements)

References 4 publications

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“…[5] Our study also shows no significant distribution according to sex (M:F = 1:1.2). In a study by Kanter et al, PAs show a predilection for females in the pediatric age group, [13] but in our study, we cannot encounter any pediatric patient. Rishi et al have shown a male predominance among NFPAs.…”

Section: Discussionmentioning

confidence: 64%

Evaluation of prognostic utility of Ki-67, P53, and O-6-methylguanine-DNA methyltransferase expression in pituitary tumors

et al. 2019

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BACKGROUND OR CONTEXT: Pituitary adenoma (PA) is the most common pathology of the pituitary gland. Pituitary tumors were historically considered benign, however, from recent advances in pathological and molecular analyses, numerous prognostic markers have been identified, allowing a better characterization of tumor behavior and prediction of response to treatment and recurrences. AIMS AND OBJECTIVES: Evaluation of the epidemiological occurrence of pituitary tumors in our center and prediction of the benign, aggressive, or malignant nature of the tumor with the help of immunohistochemical markers (IHC) Ki-67, P53, and O-6-methylguanine-DNA methyltransferase (MGMT) along with radiology. MATERIALS AND METHODS: A prospective study was done in 33 cases. Patients with clinically suspected pituitary tumors and related symptoms and signs are referred from the endocrine outpatient department and subsequently operated at the neurosurgery department were selected. We have studied the clinical features, radiology, histopathology, and IHC with the help of Ki-67, P53, and MGMT of PA over 2 years. RESULTS: We have 94% (31/33) cases of PA among them 94% (29/31) cases are macroadenoma. The IHC was conducted on 30 cases (excluding 1 case of pituitary apoplexy) where Ki-67, p53, and MGMT have been used for IHC in order to analyze the prognosis of the PA, irrespective of the immunological subtype of the PA. In our study, only 13% (4 patients) had MGMT score 0 and 2 patients, among these 4 patients having above cutoff level of Ki-67 and p53 value, considered as aggressive (in case of Ki-67 >3% and >50% in case of p53). When comparing MGMT expression with recurrence, a high degree of significance was found (Mann–Whitney U-test, P = 0.0038). Most of the recurrent tumors (6/9) had MGMT score 1 or below and most of the nonrecurring tumor had MGMT score 2 or above. When comparing MGMT expression with aggressiveness, a high degree of significance was found (Mann–Whitney U-test, P < 0.0001). Finally, combining the radiological Ki-67, p53, and MGMT values, two cases of aggressive adenoma have been seen in our study, the remaining being benign adenomas (WHO classification 2004). We did not encounter any case of pituitary carcinoma. MGMT did not show any significant correlation with radiological grading and histology. CONCLUSION: The benign, aggressive, or malignant nature of PA can be effectively predicted with the help of IHC, such as Ki-67, p53, and MGMT. This helps in better patient management and predicts recurrences and prognosis.

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Section: Discussionmentioning

confidence: 64%

Evaluation of prognostic utility of Ki-67, P53, and O-6-methylguanine-DNA methyltransferase expression in pituitary tumors

et al. 2019

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“…In the series by Kanter et al 16 an increased incidence of invasiveness was observed in adenomas where the onset of symptoms occurred during the pubertal years compared to those where symptoms first occurred during the postpubertal years. This has not been the experience in many other series.…”

Section: Discussionmentioning

confidence: 91%

Pediatric pituitary adenoma: a series of 42 patients

Pandey¹,

Ojha²,

Mahapatra³

2005

Journal of Clinical Neuroscience

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“…Estos cambios degenerativos, necróticos y hemorrágicos de una parte del adenoma le darán aspecto quístico fácil de confundir con otras lesiones 15 . Algunos autores piensan que el prolactinoma en la edad pediátrica es más invasivo 16 ; sin embargo, otros no están de acuerdo 1,4,7,9 . Se ha publicado un caso maligno en un niño de 12 años con metástasis craneoespinales 16 meses después de la extirpación del tumor primario 17 .…”

Section: Discussionunclassified

Prolactinoma: un diagnóstico que debe tenerse en cuenta en niños con neoplasias hipofisarias

García-García

Rivero-Garvía

Pérez

et al. 2009

Rev Pediatr Aten Primaria

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Resumen En la infancia y la adolescencia, los adenomas hipofisarios son raros, y la mitad de ellos son prolactinomas. Se presenta un niño de 13 años con una lesión quística selar y supraselar tratada Rev Pediatr Aten Primaria. 2009;11:607-12 Emilio García García, ggej@hotmail.com Los autores declaran no presentar conflictos de intereses en relación con la preparación y publicación de este artículo. Notas clínicas IntroducciónEl prolactinoma es el tumor hipofisario más frecuente en adultos; sin embargo, en la edad pediátrica es raro. En las series más largas publicadas, el prolactinoma es el segundo adenoma hipofisario en la infancia, tras el productor de corticotropina (ACTH), y el más fre-

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Pituitary Adenomas in Pediatric Patients: Are They more Invasive?

Cited by 16 publications

References 4 publications

Evaluation of prognostic utility of Ki-67, P53, and O-6-methylguanine-DNA methyltransferase expression in pituitary tumors

Evaluation of prognostic utility of Ki-67, P53, and O-6-methylguanine-DNA methyltransferase expression in pituitary tumors

Pediatric pituitary adenoma: a series of 42 patients

Prolactinoma: un diagnóstico que debe tenerse en cuenta en niños con neoplasias hipofisarias

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