Pituitary adenoma in adolescents: a biologically more aggressive disease?

Purpose: To determine whether pituitary adenomas behave more aggressively in patients aged 20 years or younger.

Materials And Methods: Of 178 patients with pituitary adenoma considered for radiation therapy, 18 (10.1%) were aged 20 years or younger at the time of diagnosis. Initial treatment was surgery in four of these patients, radiation therapy in one, and surgery and postoperative radiation therapy in 13. Median follow-up was 96 months.

Results: Five of the adolescent patients (28%) failed to benefit from initial treatment (four after surgery alone, one after surgery and radiation therapy). The younger patients tended to have larger tumors and a shorter mean time to progression (18 vs 75 months [P = .040]). Control with surgery plus postoperative radiation was very high (94% at 5 years).

Conclusion: Adolescents with pituitary adenoma who do not receive postoperative radiation should be followed up closely and undergo imaging at more frequent intervals than do adult patients.