Clinical characterization of pediatric supratentorial tumors and prediction of pituitary insufficiency in two tertiary centers in Saudi Arabia.

Autor:	Babiker A; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.; King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Saudi Arabia.; King Abdullah International Medical Research Centre, Saudi Arabia., Idris A; King Khalid University Hospital, Riyadh, Saudi Arabia., Aldawsari M; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia., Abu Abah M; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia., Alaqeel B; King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Saudi Arabia., Almotawa A; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia., Masuadi E; King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Saudi Arabia.; King Abdullah International Medical Research Centre, Saudi Arabia., AlShaikh A; King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Saudi Arabia.; King Abdullah International Medical Research Centre, Saudi Arabia.; King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia., Azzubi M; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Centre, Saudi Arabia., Al Dubayee M; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.; King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Saudi Arabia.; King Abdullah International Medical Research Centre, Saudi Arabia., Al Alwan I; King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.; King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Saudi Arabia.; King Abdullah International Medical Research Centre, Saudi Arabia., Maghnie M; Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy.; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Italy.
Jazyk:	angličtina
Zdroj:	International journal of pediatrics & adolescent medicine [Int J Pediatr Adolesc Med] 2022 Dec; Vol. 9 (4), pp. 196-202. Date of Electronic Publication: 2022 Dec 21.
DOI:	10.1016/j.ijpam.2022.11.001
Abstrakt:	Background: Post-operative pituitary insufficiency (PI) occurs in children with supra-tentorial tumors (STT) because of surgery or the mass effect of the tumor. We assessed the prevalence and clinical characteristics of STTs and predicted postoperative PI in our patients. Methods: This retrospective cohort study included children who underwent surgery for STT in two tertiary hospitals in Saudi Arabia (2009-2019). We focused on clinical, radiological, and histopathological features of STTs. We also used a linear regression model to predict post-operative PI. Results: The study included 55 children (1-18 years, mean: 9.5 ± 4.9 years, 32 [54%] females) with an initial presentation of STT that required surgery excluding recurrent episodes. The calculated period prevalence of STT was 18.2%, and the prevalence of postoperative PI was 58.2% (n = 32/55). The most common symptoms were headache and visual disturbances, and 20% patients had preoperative symptoms of PI. Baseline preoperative investigations for PI were performed in 60% of patients, and dynamic tests were conducted in only seven patients. A residual cortisol deficiency was presumed in 24 (43.7%) patients and 18 (32.7%) patients who developed central diabetes insipidus (DI) post-operatively. Overall, the brain imaging correlated well with the histopathological diagnosis (kappa = 0.48; P  < .001). Craniopharyngioma (n = 15/55, 27.3%) was the commonest STT. Predictive factors for a postoperative residual PI included age (10.9 ± 4.8 years; p-value = .027), female gender (p-value = .016 [OR = 8.31; 95% CI (1.48-46.71)], presentation with headache ( P value = .039 [OR = 9.27; 95% CI (1.12-76.72)]), and visual disturbances (p-value = .044 [OR = 5.07; 95% CI (1.04-24.61)]. Conclusion: STTs commonly occurred in our study population, and females were more prone to develop a residual PI. On-time surveillance of an intact endocrine system during the perioperative period is essential for the prediction and early management of PI. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2022 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)
Databáze:	MEDLINE
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