CRAN-03. PEDIATRIC PROLACTINOMA: INITIAL PRESENTATION, TREATMENT, AND LONG-TERM PROGNOSIS. Issue 2 (22nd June 2018)

• Record Type: Journal Article
• Authors: Hoffmann, Anika; Adelmann, Sarah; Claviez, Alexander; Müller, Hermann L
• Is Part Of: Neuro-oncology. Volume 20:Issue 2(2018)supplement 2
• Page Start: i37
• Page End: i37
• Publication Date: 2018-06-22
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy059.040
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: Prolactinoma is a rare pituitary adenoma secreting prolactin. Studies on diagnostics, treatment and prognosis in pediatric prolactinoma patients are rare. PATIENTS AND METHODS: We analyzed clinical presentation, response to treatment, and prognosis of 27 paediatric prolactinoma patients (10m/17f) based on patients' records. RESULTS: Tumors included 6 microadenomas (tumor volume: median 0.2 cm3, range: 0.01–0.4 cm3; serum prolactin at diagnosis: median 101 ng/ml, range: 33–177 ng/ml) 15 macroadenomas (volume: median 3.3 cm3, range: 0.4–25.8 cm3; prolactin: median 890 ng/ml, range: 87–8624), and 3 giant adenomas (volume: median 44.5 cm3, range: 38.6–93.5 cm3; prolactin: median 4720 ng/ml, range: 317–10400); data for 3 patients were not available. Dopamine agonist treatment (n=22) was safe and effective, leading to reductions in tumor size (p<0.01) and prolactin levels (p<0.01). Threat to vision was the indication for decompressing surgery in 3 of 7 operated patients. No patient was irradiated. Long-term functional capacity was not impaired when compared with other sellar masses (n=235). CONCLUSIONS: In pediatric prolactinoma, diagnosis is based on hyperprolactinemia and imaging. Dopamine agonist treatment is effective and safe. Overall-survival and functional capacity as a measure of quality of survival were not impaired, indicating an optimistic prognosis. Surgery should be considered only in emergency situations of threatened visual function, not presenting a fast response to dopamine agonist treatment. Severe side effects of medication and lack of efficacy should be considered as contraindications.