Abstract：
Pediatric pituitary adenomas (pPAs) are uncommon. Thus, their presentation and outcomes after treatment are less well-understood than those of pituitary adenomas in adulthood (aPAs).
A retrospective chart review was conducted for all patients who underwent endoscopic endonasal transsphenoidal surgery (EETS) for pPA at NewYork-Presbyterian Hospital/Weill Cornell Medicine (NYP/WCM) from 2005-2020. Eleven patients were identified, and information pertaining to age, sex, adenoma characteristics, procedural details, and outcomes was reviewed. A systematic review of the literature was also performed to compare outcomes of EETS versus microscopic endonasal transsphenoidal surgery (METS) for pPA.
From 2005-2020, 11 patients underwent EETS for pPA at NYP/WCM. Mean age at operation was 14.9 ± 2.7 years, and 5 patients (45.5%) were male. 10 adenomas (90.9%) were hormone-producing. Of the functional adenomas, 8 (80.0%) were PRL-secreting and 2 (20.0%) were GH-secreting. Maximum adenoma diameter (MAD) ranged from 1.2-5.1 cm, with a median of 1.55 cm. Cavernous sinus invasion (CSI) occurred in 2 patients with macroprolactinoma. Gross total resection (GTR) was achieved in 10 (90.9%). Biochemical remission occurred in 5/10 (50.0%). Post-operative complications were documented in 8 cases (72.7%) and included diabetes insipidus, hypopituitarism, sinusitis, weight gain, cerebrospinal fluid leak, meningitis, and hydrocephalus. Systematic literature review of 105 microscopic and 175 endoscopic cases revealed high frequency of hormone-producing tumors (83.6%) and similar rates of GTR (82.4% vs 85.1%) and biochemical cure (75.8% vs 64.3%).
pPAs are more likely to be hormone producing and may be more aggressive and difficult to cure than aPAs. EETS is an effective treatment, although complication rates may be higher than in adult populations.
A retrospective chart review was conducted for all patients who underwent endoscopic endonasal transsphenoidal surgery (EETS) for pPA at NewYork-Presbyterian Hospital/Weill Cornell Medicine (NYP/WCM) from 2005-2020. Eleven patients were identified, and information pertaining to age, sex, adenoma characteristics, procedural details, and outcomes was reviewed. A systematic review of the literature was also performed to compare outcomes of EETS versus microscopic endonasal transsphenoidal surgery (METS) for pPA.
From 2005-2020, 11 patients underwent EETS for pPA at NYP/WCM. Mean age at operation was 14.9 ± 2.7 years, and 5 patients (45.5%) were male. 10 adenomas (90.9%) were hormone-producing. Of the functional adenomas, 8 (80.0%) were PRL-secreting and 2 (20.0%) were GH-secreting. Maximum adenoma diameter (MAD) ranged from 1.2-5.1 cm, with a median of 1.55 cm. Cavernous sinus invasion (CSI) occurred in 2 patients with macroprolactinoma. Gross total resection (GTR) was achieved in 10 (90.9%). Biochemical remission occurred in 5/10 (50.0%). Post-operative complications were documented in 8 cases (72.7%) and included diabetes insipidus, hypopituitarism, sinusitis, weight gain, cerebrospinal fluid leak, meningitis, and hydrocephalus. Systematic literature review of 105 microscopic and 175 endoscopic cases revealed high frequency of hormone-producing tumors (83.6%) and similar rates of GTR (82.4% vs 85.1%) and biochemical cure (75.8% vs 64.3%).
pPAs are more likely to be hormone producing and may be more aggressive and difficult to cure than aPAs. EETS is an effective treatment, although complication rates may be higher than in adult populations.
摘要：
小儿垂体腺瘤（pPAs）并不常见。因此，与成人垂体腺瘤(aPAs)相比,人们对其治疗后的表现和结局了解较少.
对2005-2020年在纽约长老会医院/威尔康奈尔医学院（NYP/WCM）接受pPA内镜经鼻蝶手术（EETS）的所有患者进行回顾性图表回顾。确定了11名患者，和有关年龄的信息，性别,腺瘤特征，程序细节,并对结果进行了审查。还对文献进行了系统回顾，以比较EETS与显微经鼻蝶手术（METS）治疗pPA的结果。
从2005-2020年，11名患者在NYP/WCM接受了PPA的EETS。手术平均年龄14.9±2.7岁,男性5例(45.5%)。10例腺瘤（90.9%）产生激素。在功能性腺瘤中，8例(80.0%)分泌PRL,2例(20.0%)分泌GH。最大腺瘤直径(MAD)1.2-5.1cm,中位数为1.55厘米。2例大泌乳素瘤患者发生海绵窦侵犯（CSI）。10例（90.9%）实现了总切除（GTR）。生化缓解发生在5/10（50.0％）。术后并发症记录8例（72.7%），包括尿崩症，垂体功能减退,鼻窦炎,体重增加,脑脊液漏,脑膜炎,和脑积水.对105例显微镜和175例内镜病例的系统文献回顾显示，产生激素的肿瘤的频率很高（83.6％），GTR（82.4％vs85.1％）和生化治愈（75.8％vs64.3％）的发生率相似。
pPAs更有可能产生激素，并且可能比aPAs更具侵略性且难以治愈。EETS是一种有效的治疗方法，尽管并发症发生率可能高于成人人群。
对2005-2020年在纽约长老会医院/威尔康奈尔医学院（NYP/WCM）接受pPA内镜经鼻蝶手术（EETS）的所有患者进行回顾性图表回顾。确定了11名患者，和有关年龄的信息，性别,腺瘤特征，程序细节,并对结果进行了审查。还对文献进行了系统回顾，以比较EETS与显微经鼻蝶手术（METS）治疗pPA的结果。
从2005-2020年，11名患者在NYP/WCM接受了PPA的EETS。手术平均年龄14.9±2.7岁,男性5例(45.5%)。10例腺瘤（90.9%）产生激素。在功能性腺瘤中，8例(80.0%)分泌PRL,2例(20.0%)分泌GH。最大腺瘤直径(MAD)1.2-5.1cm,中位数为1.55厘米。2例大泌乳素瘤患者发生海绵窦侵犯（CSI）。10例（90.9%）实现了总切除（GTR）。生化缓解发生在5/10（50.0％）。术后并发症记录8例（72.7%），包括尿崩症，垂体功能减退,鼻窦炎,体重增加,脑脊液漏,脑膜炎,和脑积水.对105例显微镜和175例内镜病例的系统文献回顾显示，产生激素的肿瘤的频率很高（83.6％），GTR（82.4％vs85.1％）和生化治愈（75.8％vs64.3％）的发生率相似。
pPAs更有可能产生激素，并且可能比aPAs更具侵略性且难以治愈。EETS是一种有效的治疗方法，尽管并发症发生率可能高于成人人群。
