Abstract
Purpose
To explore the clinical characteristics, treatment, and prognosis of growth hormone-secreting pituitary adenoma (GHPA) patients with pediatric-onset, so as to facilitate the clinical management.
Methods
A retrospective cohort study was carried out between 102 pediatric-onset GHPA patients admitted to our hospital from January 2013 to June 2022 and 204 adult-onset GHPA patients who were randomly matched.
Results
GHPA with pediatric-onset was predominantly male, associated with higher proportion of genetic syndromes, longer course, and delay on diagnosis. Clinical symptoms of visual field defects and menstrual abnormality were more common. The pediatric-onset group presented with higher growth hormone (GH) nadir during oral glucose tolerance test (OGTT), higher rates of hyperprolactinemia, larger maximum diameter of adenoma, higher rates of optic chiasm compression, suprasellar invasion, and pituitary apoplexy. Hypertension, diabetes, and obstructive sleep apnea-hypopnea syndrome (OSAHS) were more common in the adult-onset group. Echocardiography results were similar between the two groups. The pediatric-onset group owned significantly higher treatment scores and proportions of multimodal therapy modality, more surgical complications, and a higher proportion of ki67 ≥ 3%. There was no significant difference in the final cure rate, but male patients with adult-onset had a worse prognosis. The recurrence rate was also similar between two groups. Hypopituitarism was more prevalent in the pediatric-onset group, while the adult-onset group had a higher rate of combining other tumors.
Conclusion
The clinical characteristics of pediatric-onset GHPA patients were different from adult-onset patients. Multimodal therapy modalities could help to achieve a cure rate similar to that of adult-onset patients.