Abstract
BACKGROUND
Prolactinoma is a rare pituitary adenoma secreting prolactin. Studies on diagnostics, treatment and prognosis in pediatric prolactinoma patients are rare. PATIENTS AND
METHODS
We analyzed clinical presentation, response to treatment, and prognosis of 27 paediatric prolactinoma patients (10m/17f) based on patients’ records.
RESULTS
Tumors included 6 microadenomas (tumor volume: median 0.2 cm3, range: 0.01–0.4 cm3; serum prolactin at diagnosis: median 101 ng/ml, range: 33–177 ng/ml) 15 macroadenomas (volume: median 3.3 cm3, range: 0.4–25.8 cm3; prolactin: median 890 ng/ml, range: 87–8624), and 3 giant adenomas (volume: median 44.5 cm3, range: 38.6–93.5 cm3; prolactin: median 4720 ng/ml, range: 317–10400); data for 3 patients were not available. Dopamine agonist treatment (n=22) was safe and effective, leading to reductions in tumor size (p<0.01) and prolactin levels (p<0.01). Threat to vision was the indication for decompressing surgery in 3 of 7 operated patients. No patient was irradiated. Long-term functional capacity was not impaired when compared with other sellar masses (n=235).
CONCLUSIONS
In pediatric prolactinoma, diagnosis is based on hyperprolactinemia and imaging. Dopamine agonist treatment is effective and safe. Overall-survival and functional capacity as a measure of quality of survival were not impaired, indicating an optimistic prognosis. Surgery should be considered only in emergency situations of threatened visual function, not presenting a fast response to dopamine agonist treatment. Severe side effects of medication and lack of efficacy should be considered as contraindications.