Pituitary tumour apoplexy within prolactinomas in children: a more aggressive condition?

Pituitary. 2018 Oct;21(5):474-479. doi: 10.1007/s11102-018-0900-8.

Abstract

Objectives: To evaluate clinical presentations, diagnosis and management of paediatric patients presenting with pituitary apoplexy.

Methods: A retrospective case series describing a cohort of paediatric patients presenting with this condition from 2010-2016 to a tertiary referral children's hospital in the United Kingdom.

Results: Pituitary apoplexy is a rare condition that seems to have a higher relative incidence in children than adults. Our series suggests that pituitary apoplexy in paediatric patients with adenomas appears more common than previously described. All our patients required surgery, either as an acute or delayed procedure, for visual compromise. Two patients had commenced growth hormone (GH) for GH deficiency two weeks prior to the onset of pituitary apoplexy.

Conclusions: With only a limited number of published case reports surrounding this topic our case series contributes to help further understand and manage this condition.

Keywords: Adenoma; Apoplexy; Children; Endoscopic; Haemorrhage; Pituitary; Prolactinoma; Surgery; Trans-sphenoidal.

MeSH terms

  • Adolescent
  • Female
  • Growth Hormone / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pituitary Apoplexy / diagnosis*
  • Pituitary Apoplexy / diagnostic imaging*
  • Pituitary Apoplexy / drug therapy
  • Pituitary Neoplasms / diagnosis*
  • Pituitary Neoplasms / diagnostic imaging*
  • Pituitary Neoplasms / drug therapy
  • Prolactinoma / diagnosis*
  • Prolactinoma / diagnostic imaging*
  • Prolactinoma / drug therapy
  • Retrospective Studies

Substances

  • Growth Hormone