Transsphenoidal Surgery for Pituitary Adenomas in Children
| Autor: | A. Visot, O. Delalande, Patrick Derome, Thierry Civit, Dyer Eh |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adenoma
Male Pituitary gland medicine.medical_specialty Sphenoid Sinus medicine.medical_treatment Preoperative care Paraneoplastic Endocrine Syndromes Cushing syndrome Postoperative Complications Humans Medicine Pituitary Neoplasms Prolactinoma Child Hypophysectomy Transsphenoidal surgery business.industry Nelson Syndrome medicine.disease Magnetic Resonance Imaging Surgery Radiation therapy medicine.anatomical_structure Child Preschool Growth Hormone Hormones Ectopic Female Neurology (clinical) Neoplasm Recurrence Local Tomography X-Ray Computed business Follow-Up Studies |
| Zdroj: | Neurosurgery. 34:207-212 |
| ISSN: | 1524-4040 0148-396X |
| DOI: | 10.1227/00006123-199402000-00001 |
| Popis: | The authors have reviewed the results of transsphenoidal surgery for pituitary adenomas done on 66 children (younger than 16 yr of age) between 1966 and 1992. Ninety-four percent (62 of 66) showed clinical evidence of pituitary hormonal hypersecretion. The most common type was the adrenocorticotropic hormone-secreting adenoma (n = 36), followed by the prolactinoma (n = 18) and the growth hormone-secreting types (n = 8). There were four cases of nonfunctioning adenomas. Adrenocorticotropic hormone-secreting tumors in children had presentations and surgical results similar to those seen in adults. Twenty-three of 33 patients with Cushing's disease had simple adenomectomy or subtotal hypophysectomy without symptomatic recurrence. Four of 10 initial treatment failures had subsequent successful surgical intervention, resulting in an overall cure rate of 78%. Postoperative hypocortisolism was suggestive of surgical success but was not absolute. Of three patients with Nelson syndrome, none were successfully treated with surgery alone and two developed invasive disease. Prolactin-secreting and growth hormone-secreting tumors in children occurred more commonly with suprasellar expansion than did their adult counterparts. Transsphenoidal surgery was capable of controlling disease in only 12% (1 of 8) of growth hormone-secreting tumors, and 67% (12 of 18) of prolactin-secreting tumors required postoperative medical therapy or radiotherapy for persistently elevated prolactin levels. Special difficulty was noted in boys with prolactinomas and in girls with primary amenorrhea. As in adults, preoperative prolactin levels correlated with ultimate surgical success rates.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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