Introduction: Prolactinomas are the most common pituitary adenomas in paediatric patients, except in the first decade of life, when ACTH secreting adenomas are more frequent.
Objective: Analysis of clinical, diagnostic and therapeutic data of prolactinomas in paediatric age.
Methods: Retrospective study of 15 patients whose symptoms began before 18 years of age.
Results: In girls, secondary amenorrhea (58.3%) and galactorrhea (41.7%) raised diagnostic investigation whereas in boys (all macroadenomas) this was made by mass effect symptoms. All patients were treated with dopamine agonists and one was submitted to transsphenoidal surgery. Nowadays, 8 have normal prolactin levels, 2 without therapy; the remaining have high levels but are asymptomatic.
|No of boys/girls||3/4||0/8|
|Age at beginning of symptoms* (year)||15.4±1.9||15±2.4|
|Age at diagnosis* (year)||18±2.9||18.8±6.4|
|Basal prolactin levels*(elevation above reference)||35.7±40.2||4.2±1.6|
Discussion: Most cases were diagnosed after 18 years of age, with a mean of 3 years between the beginning of symptoms and diagnosis. In females, menstrual irregularities and galactorrhea may have led to a precocious investigation and higher prevalence of microadenomas. In males, mass effects symptoms caused by larger lesions prevailed since endocrine symptoms are insidious and more difficult to notice. Treatment with dopamine agonists was effective and without major side effects.
Conclusion: Prolactinomas should always be considered in the evaluation of menstrual irregularities in girls or pubertal delay in both sexes. They assume special importance because of good outcomes with medical treatment in normalizing prolactin levels and reducing tumour size.
03 - 07 May 2008
European Society of Endocrinology