Multidisciplinary treatment of giant invasive prolactinomas in paediatric age: long-term follow-up in two children.
BACKGROUND
Invasive giant prolactinomas are rare tumours, still representing a therapeutic challenge due to their characteristics of invasiveness and variable clinical course. Giant prolactinomas in childhood are extremely rare. Only single case reports have been described in the literature.


METHODS
We report on two children who presented a progressive visual deterioration. Magnetic resonance imaging showed extensive intra-suprasellar tumour invading the anterior skull base. The laboratory investigations detected markedly elevated prolactin levels. The patients were firstly started on dopamine agonist therapy with partial reduction in size of the tumours. The debulking of the residual lesions through a transsphenoidal approach was then performed in both patients, one of whom requiring a second surgical procedure for tumour regrowth. The complete shrinkage of the residual adenomas was achieved after the treatment with conventional radiotherapy, with a follow-up of 13 and 14 years, respectively.


CONCLUSIONS
Multidisciplinary therapeutic approach for giant prolactinomas in paediatric patients can be an effective treatment; despite the invasiveness of these tumours, the efficacy of this combined treatment can reach a satisfactory control of the disease at long term, assuring a good quality of life as well.
Fraioli
Mario Francesco
MF
Department of Neurosurgery, University of Rome Tor Vergata, Viale Oxford 81, Rome, Italy.
Novegno
Federica
F
Catena
Elisabetta
E
Fraioli
Chiara
C
Moschettoni
Laura
L
D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000473:pathology / Q000628:therapy*; D015175:Prolactinoma / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome