title: Endocrine diagnosis and treatment of sellar lesions in pediatric age.
abstract: BACKGROUND
  Sellar masses are an heterogeneous group of lesions, both in nature and management. Not all of them require surgery.
  
  
  OBJECTIVE
  To describe the presenting symptoms of sellar masses and endocrine abnormalities occurring during follow-up. To emphasize the significance of endocrine assessment, and to identify lesions amenable to hormonal treatment.
  
  
  METHODS
  A retrospective review of the records of children under 14 years of age referred to our center for sellar lesions during 12 years. Data collected included sex, age, nature of lesion, clinical presentation, size, treatment, and endocrine abnormalities.
  
  
  RESULTS
  Forty-five patients (25 females) aged 7.2 ± 4.1 years (range 0.25-13.5) were enrolled. Follow-up time was 6.2 ± 3.7 years. Lesion nature was known in 39 cases, 4 of which were successfully treated at the Endocrinology Department: 3 prolactinomas (with dopamine agonist) and one thyrotroph cell hyperplasia (with levothyroxine). The most common presenting symptoms were neurological and/or visual (25/45), followed by endocrine conditions (13/45). Duration of endocrine and neuro-ophthalmic symptoms was 12.6 ± 18.2 months and 2.6 ± 4.9 (P=.012), respectively. Some endocrine condition was found in 24/45 patients at the initial evaluation and in 37/45 patients at the end of follow-up.
  
  
  CONCLUSIONS
  Management of sellar lesions requires a multidisciplinary effort. Endocrine tests are indispensable to identify lesions amenable to hormonal treatment. Endocrine disorders usually occurred before neurological and ophthalmological symptoms, and their identification may therefore allow for earlier diagnosis. Hormone assessment should be regularly performed during follow-up.
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: ejgg67@gmail.com.
authors.forename: Emilio
authors.initials: E
authors.lastname: García-García
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: González-Aguilera
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Noelia
authors.initials: N
authors.lastname: Gros
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Romero-Lluch
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Jiménez-Varo
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Martínez-Ortega
authors.affiliation: Unidad de Endocrinología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Aliaga-Verdugo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D007223:Infant; D008297:Male; D012189:Retrospective Studies
keywords: Adolescent; Adolescente; Child; Enfermedades hipofisarias; Hypothalamic-pituitary neoplasms; Neoplasias hipotálamo-hipofisarias; Niño; Pituitary diseases