Introduction: Pituitary gland tumors are rare during childhood. Pituitary adenomas represent less than 3% of all supratentorial tumors in children and pituitary carcinomas are extremely unusual. Although sporadic, these tumors do occur, challenging health professionals due to to their endocrine and neurological characteristics, diverse from those tumors arising in adult patients.
These specific characteristics and rarity may delay the diagnosis, increasing morbidity and mortality. Besides that, there are a few studies reporting the profile of pituitary tumors in this age group.
Methods: A single institution retrospective review was performed of all pituitary gland tumors, surgically treated at Hospital Santa Isabel - Brazil, from 2012 to 2017. All patients under 18 years old by the time of the surgical procedure were selected. Gender, age, tumor size, histopathological characteristics, symptoms and time from first symptoms to the diagnosis were evaluated.
Results: From all 178 pituitary gland tumors surgically treated in our institution, eight patients met the study inclusion criteria (4,49%). Most tumors occurred in male patients (75%), with a mean age of presentation around 14 years old. Seven patients had a pituitary adenoma, most being macroadenomas. One patient had a primary pituitary lymphoma. Among the patients with adenomas, 3 were prolactinomas, one was a non-functional adenoma and two had Cushing`s disease. Despite the variety of hormonal features, the most frequent complaints were growth failure and delayed puberty, including the patient with the pituitary lymphoma. There was a mean time of 15 months from symptoms to the pituitary tumor diagnosis.
Conclusions: Although rare, pituitary tumors should be remembered in children, especially in those with growth failure. Interdisciplinary effort with endocrinology colleagues seems to be key, in order to establish an early and accurate diagnosis, increasing chances of surgical cure.
Patient Care: Emphasize the occurrence of pituitary tumor in children and the importance of proper investigation, especially in those presenting with growth failure
Learning Objectives: Discuss the epidemiological features and clinical presentation of pituitary gland tumors in children.