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Pituitary Adenoma in Pediatric and Adolescent Populations.

Abstract
Pituitary adenomas are rare in children and adolescents and although mostly benign, they can sometimes be challenging to manage due to their locally invasive nature. In this study, we examined the clinicopathologic features of 42 pituitary adenomas in patients ≤21 years of age. The youngest patient was 8 years old (median age: 18 years), and the female-to-male ratio was 1.8:1. Five patients had recurrence after resection. There was no obvious difference between the recurrent rates in the typical (11.7%) and atypical adenomas (12.5%) based on the 2004 WHO classification. However, the recurrence rate was much higher in adenomas with an elevated proliferation index of ≥3% (20.8%) or with evidence of local invasion (18.2%). Adenomas with combination of an elevated proliferation index of ≥3% and imaging evidence of local invasion had the highest recurrence rate of 25%. In summary, pituitary adenomas are more frequent in adolescents as compared with children and are more common in girls. An elevated proliferation index of ≥3% and evidence of local invasion on imaging seem to correlate with a high probability of recurrence. Furthermore, we observe rarity of α-thalassemia/mental retardation syndrome X-linked (ATRX) protein loss (surrogate to ATRX mutation) in these tumors without any connotation on prognosis.
AuthorsJie Chen, Robert E Schmidt, Sonika Dahiya
JournalJournal of neuropathology and experimental neurology (J Neuropathol Exp Neurol) Vol. 78 Issue 7 Pg. 626-632 (07 01 2019) ISSN: 1554-6578 [Electronic] England
PMID31115468 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2019 American Association of Neuropathologists, Inc.
Chemical References
  • ATRX protein, human
  • X-linked Nuclear Protein
Topics
  • Adenoma (epidemiology, pathology)
  • Adolescent
  • Age Distribution
  • Cell Proliferation
  • Child
  • Female
  • Humans
  • Male
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Pituitary Neoplasms (epidemiology, pathology)
  • Prognosis
  • Retrospective Studies
  • Sex Characteristics
  • X-linked Nuclear Protein (genetics)
  • Young Adult

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