title: Prolactinomas in children under 14. Clinical presentation and long-term follow-up.
abstract: OBJECTIVE
  Pediatric prolactinomas are rare, especially in children under 14 years of age. In this study, we evaluated the clinical presentation and microsurgical outcome of prolactinomas in prepubertal children.
  
  
  METHODS
  Nine patients with prolactinomas who had undergone surgical removal of the tumor before the age of 14 years were included in this retrospective study. Data on their clinical presentation, medications, physical and laboratory evaluations, radiological findings, and long-time follow-up were obtained from their medical records.
  
  
  RESULTS
  The main presenting symptom in the four female patients was galactorrhea (n = 4, 100%), whereas the five male patients most commonly presented with headache (n = 4, 80%) and growth retardation (n = 3, 60%). Six (66.6%) of the patients who had undergone transsphenoidal surgery were medication-free postoperatively. In three (33.3%) patients with giant adenomas, complete resection of the tumor was not achieved. One (11.1%) patient received radiotherapy after failed surgical and medical treatment. Postoperatively, electrolyte disturbances occurred in five (55.6%) patients, diabetes insipidus in two (22.2%), and thyroid dysfunction in two (22.2%). These complications resolved spontaneously. During follow-up, growth and puberty were usually normal.
  
  
  CONCLUSIONS
  Tumor compressive symptoms and/or gonadal and growth arrest may be the primary clinical presentations of pediatric prolactinoma. Patients who are not candidates for dopamine agonist therapy are best treated surgically, based on the low mortality and high cure rates. Hypopituitarism is a rare complication and may resolve spontaneously. Following successful treatment of a prolactinoma, growth and puberty in these children are normal.
authors.affiliation: Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Yao
authors.forename: Bing
authors.initials: B
authors.lastname: Xing
authors.forename: Wei
authors.initials: W
authors.lastname: Lian
authors.forename: Kan
authors.initials: K
authors.lastname: Deng
authors.forename: Ming
authors.initials: M
authors.lastname: Feng
authors.forename: Renzhi
authors.initials: R
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D010902:Pituitary Gland / Q000601:surgery; D010911:Pituitary Neoplasms / Q000097:blood / Q000601:surgery*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D011388:Prolactin