Rivera-Hernández A, Peralta-Cortázar C, Nishimura-Meguro E

Language: Spanish
References: 24
Page: 181-185
PDF size: 263.25 Kb.

ABSTRACT

Background and objective: Pituitary adenomas in children are rare, annual incidence has been estimated to be 0.1 per million. Medical management is similar to adults but clinical behavior differs. The objective is to describe the clinical characteristics and follow–up of pediatric patients with prolactinomas. Material and methods: We reviewed the files of all patients in the Hospital Pediatría CMN SXXI with a prolactinoma diagnosis from January 2000 to December 2010. Results: We report 13 girls and 3 boys. The mean age was 12.8 years, mean serum prolactin at the time of diagnosis was 1,368 ng/mL (856 vs 3,586) and a macrolactinoma was present in 62 of boys and 100% in girls. At diagnosis 31% of cases presented delayed onset or progression of puberty at least by 2 years. Eleven girls received bromocriptine as first treatment, one of them responded favorably and three cases were intolerant. 12 girls were treated with cabergoline and prolactin levels normalized in 80% of microprolactinomas and 100% of macroprolactinomas. The three male cases, all of them with invasive macroprolactinomas, were initially treated with surgery and required also cabergoline. Despite further treatment, two cases didn’t achieve normoprolactinemia. Conclusion: The clinical behavior in our cases differs from international reports, we have more cases with macroprolactinoma in both gender and maybe less diagnostic opportunity. In the adolescents, the initial clinical manifestation was delayed onset or progression of puberty. We suggest to be more careful with the follow up of the growth and pubertal development of the apparently healthy children.

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