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Non-functioning pituitary microadenoma in children and adolescents : Is follow-up with diagnostic imaging necessary?

Borghammar, Camilla LU orcid ; Tamaddon, Ashkan LU ; Erfurth, Eva-Marie LU ; Sundgren, Pia C LU orcid ; Siesjö, Peter LU orcid ; Elfving, Maria LU and Nilsson, Margareta (2023) In Endocrine 79. p.152-160
Abstract

PURPOSE: No consensus exists regarding follow-up recommendations for suspected pituitary microadenoma in children. To address this knowledge gap, we investigated the growth potential of pituitary solid and cystic lesions <10 mm in children and evaluated the accuracy of magnetic resonance imaging (MRI) measurements.

METHODS: The children included were <18 years at first pituitary MRI and radiologically diagnosed with a non-functioning microadenoma or cyst <10 mm. Lesion size at first and latest MRI as well as all individual MRI examinations were re-evaluated.

RESULTS: In total, 74 children, median age 12 years (range 3-17), had a non-functioning microadenoma, probable microadenoma, or cyst. Of these, 55 underwent... (More)

PURPOSE: No consensus exists regarding follow-up recommendations for suspected pituitary microadenoma in children. To address this knowledge gap, we investigated the growth potential of pituitary solid and cystic lesions <10 mm in children and evaluated the accuracy of magnetic resonance imaging (MRI) measurements.

METHODS: The children included were <18 years at first pituitary MRI and radiologically diagnosed with a non-functioning microadenoma or cyst <10 mm. Lesion size at first and latest MRI as well as all individual MRI examinations were re-evaluated.

RESULTS: In total, 74 children, median age 12 years (range 3-17), had a non-functioning microadenoma, probable microadenoma, or cyst. Of these, 55 underwent repeated MRI (median 3, range 2-7) with a median follow-up of 37 months (range 4-189). None of the pituitary lesions without hormonal disturbances increased significantly during follow-up. Two radiologists agreed that no lesion could be identified in 38/269 (14%) MRI examinations, and in 51/231 (22%) they disagreed about lesion location. In 34/460 (7%) MRI measurements size differed >2 mm, which had been considered significant progression.

CONCLUSION: Non-functioning pituitary microadenoma in children has small size variations, often below the spatial resolution of the scanners. We suggest lesions <4 mm only for clinical follow-up, lesions 4-6 mm for MRI after 2 years and ≥7 mm MRI after 1 and 3 years, with clinical follow-up in between. If no progression, further MRI should only be performed after new clinical symptoms or hormonal disturbances.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Endocrine
volume
79
pages
152 - 160
publisher
Springer
external identifiers
  • scopus:85140041420
  • pmid:36251115
ISSN
1355-008X
DOI
10.1007/s12020-022-03212-7
language
English
LU publication?
yes
additional info
© 2022. The Author(s).
id
7e685571-b99f-4319-8daa-a46cd6f9dbaa
date added to LUP
2022-10-22 14:24:43
date last changed
2025-04-19 02:19:11
@article{7e685571-b99f-4319-8daa-a46cd6f9dbaa,
  abstract     = {{<p>PURPOSE: No consensus exists regarding follow-up recommendations for suspected pituitary microadenoma in children. To address this knowledge gap, we investigated the growth potential of pituitary solid and cystic lesions &lt;10 mm in children and evaluated the accuracy of magnetic resonance imaging (MRI) measurements.</p><p>METHODS: The children included were &lt;18 years at first pituitary MRI and radiologically diagnosed with a non-functioning microadenoma or cyst &lt;10 mm. Lesion size at first and latest MRI as well as all individual MRI examinations were re-evaluated.</p><p>RESULTS: In total, 74 children, median age 12 years (range 3-17), had a non-functioning microadenoma, probable microadenoma, or cyst. Of these, 55 underwent repeated MRI (median 3, range 2-7) with a median follow-up of 37 months (range 4-189). None of the pituitary lesions without hormonal disturbances increased significantly during follow-up. Two radiologists agreed that no lesion could be identified in 38/269 (14%) MRI examinations, and in 51/231 (22%) they disagreed about lesion location. In 34/460 (7%) MRI measurements size differed &gt;2 mm, which had been considered significant progression.</p><p>CONCLUSION: Non-functioning pituitary microadenoma in children has small size variations, often below the spatial resolution of the scanners. We suggest lesions &lt;4 mm only for clinical follow-up, lesions 4-6 mm for MRI after 2 years and ≥7 mm MRI after 1 and 3 years, with clinical follow-up in between. If no progression, further MRI should only be performed after new clinical symptoms or hormonal disturbances.</p>}},
  author       = {{Borghammar, Camilla and Tamaddon, Ashkan and Erfurth, Eva-Marie and Sundgren, Pia C and Siesjö, Peter and Elfving, Maria and Nilsson, Margareta}},
  issn         = {{1355-008X}},
  language     = {{eng}},
  pages        = {{152--160}},
  publisher    = {{Springer}},
  series       = {{Endocrine}},
  title        = {{Non-functioning pituitary microadenoma in children and adolescents : Is follow-up with diagnostic imaging necessary?}},
  url          = {{http://dx.doi.org/10.1007/s12020-022-03212-7}},
  doi          = {{10.1007/s12020-022-03212-7}},
  volume       = {{79}},
  year         = {{2023}},
}