Pituitary Adenomas in Children: : Specific Imaging Features According to Hormonal Secretion.

Purpose: Pituitary adenomas are much rarer in children than in adults. We aimed to analyze their imaging characteristics in this age group and to compare them according to the hormonal secretion. We conducted an observational monocentric retrospective study on clinical and imaging data.

Methods: We analyzed imaging features before surgery or drug treatment of pituitary adenomas in children confirmed by histopathology or hormonal secretion. We assessed tumoral signal intensity, volume and aggressiveness, and compared it according to the hormonal secretion.

Results: We included 31 children (13 lactotroph (42%), 8 corticotroph (26%), 5 somatotroph (16%), 5 plurihormonal adenomas (16%) including 1 non-secreting macroadenoma) with a median age of 13 years (range 2-16 years-old), without age or sex difference between secretion types. Lactotroph and somatotroph adenomas were larger than corticotroph adenomas (p = 0.007) and were more aggressive (p = 0.01). They also had higher signal intensity on T2-weighted images (p = 0.04). T1 signal intensity was similar between the groups on pre and post-contrast images (lower enhancement than the normal pituitary). No non-secreting micro-adenoma became clinically significant enough to lead to a pathological confirmation or specific treatment. Genetic research was conducted on 20 children, finding MEN1 mutations in 80% of the patients.

Conclusions: Pituitary adenomas in children are rare but should be considered when facing similar imaging features than in adults. Imaging characteristics may allow to suspect the hormonal secretion.