Abstract
Dependent on site and size, pituitary hormone deficits may be associated with space-occupying lesions in the pituitary and suprasellar regions (craniopharyngyoma, adenoma and germinoma). Medical awareness of such a lesion however tends to be alerted more quickly to mass effects rather than the associated hormone deficiencies. Apart from the lesion itself, hypopituitarism may be induced by surgery and/or radiotherapy. The deficit with surgery may be transient or permanent but occurs promptly whilst hypopituitarism following irradiation is delayed and dose dependent. The hormone-producing pituitary adenomas met in paediatric practice, albeit rarely, are prolactin, GH and ACTH-secreting. Surgery is the treatment of choice for ACTH and GH-secreting adenomas although debate remains about the definition of cure and recurrence rates. The role of medical therapy is usually adjunctive to surgery or radiotherapy however octreotide, a somatostatin analogue appears to offer a promising new approach for GH-secreting adenomas. Treatment of choice for prolactinomas is contentious but dopamine agonist therapy has a prominent place. In the majority of children treated for hormone-secreting pituitary adenomas endocrine “cure” may be achieved but in a significant proportion hormone replacement therapy will be required permanently.
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Shalet, S. ENDOCRINE OUTCOME. Pediatr Res 33 (Suppl 5), S11 (1993). https://doi.org/10.1203/00006450-199305001-00050
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DOI: https://doi.org/10.1203/00006450-199305001-00050