Non-functioning pituitary microadenoma in children and adolescents : Is follow-up with diagnostic imaging necessary?
(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.
(Less)
- author
- Borghammar, Camilla
LU
; Tamaddon, Ashkan
LU
; Erfurth, Eva-Marie
LU
; Sundgren, Pia C
LU
; Siesjö, Peter
LU
; Elfving, Maria
LU
and Nilsson, Margareta
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Endocrine
- volume
- 79
- pages
- 152 - 160
- publisher
- Springer
- external identifiers
-
- pmid:36251115
- scopus:85140041420
- 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
- 2025-10-18 18:53:20
@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 <10 mm in children and evaluated the accuracy of magnetic resonance imaging (MRI) measurements.</p><p>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.</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 >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 <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}},
}