PITUITARY-TUMORS IN ADOLESCENT PATIENTS

We report on a series of 48 patients, ages 14 to 20 year, with hypophy seal adenomas. Of these, 46 (96%) had secreting tumors, 3 had Gushing' s disease, 9 had somatotrophinomas, and 34 (29 females and 5 males) ha d prolactinomas. Thirty cases were diagnosed as intrasellar adenomas ( 62%) while the remaining eighteen (38%) presented extrasellar expansio n. Of 9 acromegalic patients, 7 had typical clinical and biochemical f eatures while 2 were exclusively prognatic with normal basal GH levels , but abnormal dynamic tests. Prolactinomas were noninvasive in women and faster growing and more extensive in men. Forty seven patients und erwent surgery. Five of these required craniotomy and the rest were ap proached through the sphenoidal bone (TSE). Remission was achieved in Gushing's disease, acromegaly, and female intrasellar prolactinomas. L arger tumors such as nonsecreting adenomas and male prolactinomas show ed poor results after undergoing subtotal resections, with persistance of endocrinological disturbances. From our findings it appears that t hese tumors are not more aggressive in youths than in adults. Because there was a close relationship between tumor size, invasiveness, and t he patients' final outcome, we conclude that early diagnosis and treat ment is essential. Frequent complaints in adolescents such as irregula r menses, retarded puberty, and growth disorders should be thoroughly investigated and not merely considered as transient or 'functional'.