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

Abstract Object 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. Methods Eighty consecutive patients younger than 20 years with PAs who underwent surgery were included. The study cases were divided into an apoplexy group and non-apoplexy group, and the corresponding clinical data were statistically analyzed and compared between these two groups. Results The study included 33 males and 47 females, with a mean age of 16.9 years. There were six (7.5%) ACTH-secreting, 13 (16.3%) GH-secreting, 47 (58.7%) PRL-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. Preoperatively, patients in the apoplexy group were more likely to have visual impairment (P = 0.033, HR = 2.841, 95% CI = 1.073–7.519) and had poorer visual impairment scores than those in the non-apoplexy group (P = 0.027). Although not statistically significant, apoplexy may have been associated with a higher Ki-67 proliferation index (P = 0.070). However, apoplexy was not associated with tumor type, tumor size, resection rate, or tumor recurrence. Conclusion Tumor apoplexy was common in pediatric and adolescent patients with PAs, and was associated with more severe preoperative visual deficits. Hence, appropriate surgical treatment may be important for salvaging visual function in young PA patients.