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Comparative analysis of pituitary adenoma with and without apoplexy in pediatric and adolescent patients: a clinical series of 80 patients

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Abstract

Pituitary adenomas (PAs) have a low incidence in pediatric and adolescent patients, and their clinical characteristics remain unclear. As a severe complication of PA, apoplexy was investigated in young patients in the present study. Eighty patients younger than 20 years with PAs who underwent surgery were included and divided into an apoplexy group and non-apoplexy group. The clinical data of these two groups were statistically analyzed and compared. The study included 33 boys and 47 girls, with a mean age of 16.9 years. There were six (7.5%) adrenocorticotropic hormone–secreting, 13 (16.3%) growth hormone–secreting, 47 (58.7%) prolactin-secreting, and 14 (17.5%) non-functioning PAs. There were 34 (42.5%) patients in the apoplexy group and 46 (57.5%) patients in the non-apoplexy group. Pre-operatively, patients in the apoplexy group were more likely to have visual impairment (hazard ratio: 2.841, 95% confidence interval: 1.073–7.519; P = 0.033) and had poorer visual impairment scores than those in the non-apoplexy group (P = 0.027). Furthermore, a longer duration of symptoms before surgery was significantly correlated with a poorer visual outcome in the apoplexy group (R =  − 1.204; P = 0.035). However, apoplexy was not associated with tumor type, tumor size, resection rate, or tumor recurrence. Tumor apoplexy is common in pediatric and adolescent patients with PAs and is associated with more severe preoperative visual deficits. Hence, the appropriate timing of surgical treatment may be important for rescuing visual function in young PA patients.

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Funding

This study was funded by grants from the LiaoNing Revitalization Talents Program (no. XLYC1807253) and ShenYang Science and Technology Innovation Project (no. RC200610). Sheng Han had received this funding.

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Authors and Affiliations

  1. Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China

    Run Wang, Zixun Wang, Yifu Song, Longjie Li, Xiaodi Han & Sheng Han

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  1. Run Wang
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  2. Zixun Wang
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  3. Yifu Song
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  4. Longjie Li
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  5. Xiaodi Han
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Contributions

R. W., Z. W., Y. S., L. L., and X. H. cooperated to complete the study. R. W., Z. W., L. L., X. H., and S. H. contributed to the collection and analysis of data. R. W., Z. W., and Y. S. participated in drafting the text and figures. S. H. designed the study and provided guidance in drafting the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Sheng Han.

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This study was approved by the institutional review board of the First Hospital of China Medical University. Written informed consent was obtained from each patient and their parent(s) for the use of clinical data for future research.

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Written informed consent was obtained from each patient and their parent(s) for publication.

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The authors declare no competing interests.

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Wang, R., Wang, Z., Song, Y. et al. Comparative analysis of pituitary adenoma with and without apoplexy in pediatric and adolescent patients: a clinical series of 80 patients. Neurosurg Rev 45, 491–498 (2022). https://doi.org/10.1007/s10143-021-01551-z

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  • DOI: https://doi.org/10.1007/s10143-021-01551-z

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