Sellar and Pituitary Tumors in Children

Abstract

Sellar and parasellar tumors are rare in children and adolescents, but can be associated with significant morbidity. In addition to clinical features resulting from mass effect, and hormonal insufficiencies and excess depending on the nature of the tumor, children with these tumors often present with a slowing of growth velocity and pubertal delay, features unique to children and adolescents. Craniopharyngiomas are the most common sellar/pituitary tumors in children, accounting for 80–90% of these tumors, followed by pituitary adenomas. As in adults, prolactinomas are the most common pituitary adenomas seen in children and adolescents, followed by ACTH secreting adenomas. Suprasellar germinomas in children present classically with diabetes insipidus with or without other pituitary hormone deficiencies and visual field deficits. Treatment for pituitary tumors is typically surgery, with the exception of prolactinomas, treated effectively in most instances with dopamine agonist therapy. Germinomas are very sensitive to chemotherapy and radiotherapy, but use of radiotherapy in children is otherwise limited to tumor recurrence after surgery or tumor occurrence in surgically inaccessible areas.