ESPE Abstracts (2018) 89 LB-P-19

Characterization and Clinical Course of Prolactinoma in Korean Adolescents

Aram Yanga, Minji Imb, Ari Songb, Jinsup Kimb, Hyung-Jin Shinc, Hwan-Hee Parkb, Sung Yoon Chob,d & Dong-Kyu Jinb,d

aInha University Hospital, Seoul, Republic of Korea; bDepartment of Pediatrics, Samsung Medical Center, Seoul, Republic of Korea; cDepartment of Neurosurgery, Samsung Medical Center, Seoul, Republic of Korea; dSungkyunkwan University School of Medicine, Seoul, Republic of Korea

Prolactinoma is most common functioning pituitary adenoma(50%). However, there have been limited studies for prolactinoma in adolescents. Pituitary adenomas are uncommon in childhood and adolescence (<3% of childhood supratentorial tumors, 3–6% of all surgically treated adenomas). The aim of this study is to assess the characteristics of Korean adolescents with prolactinoma and their clinical course. This study is retrospective cohort study. Patients diagnosed with prolactinoma (age < 19 years) in Samsung Medical Center during a 13-year period (2005–2017). Study subjects are (1) Total 25 patients (20 female/5male), (2) Median age is 16.9, ranged from 10.1 to 18.5, (3) divided into two groups according to tumor size, (4) 11 microadenomas and 14 macroadenomas, (5) factors related to tumor size were evaluated. (6) Surgery group (n=14) and non-surgery group (n=11). The results are presented as the mean (S.D.) or mean change (S.D.). The relationship of each risk factor with macroprolactinoma was defined by logistic regression analysis. Correlations between macroprolactinoma and other variables were determined by Spearman rank order correlation. All statistical analysis was performed using SPSS Statistics 24 (IBM Corporation, USA). The most common clinical manifestations are galactorrhea (40%), amenorrhea (36%), visual field defect (16%), and headache (12%). Patients are diagnosed by 11 microadenomas and 14 macroadenomas. Prolactin level at diagnosis was significantly higher in macroadenoma group (516 vs 114.2 ng/ml, P < 0.001). Patient diagnosed to panhypopituitarism is 1 (9%) in microadenoma patients, 10 (71%) in macroadenoma patients (P=0.008). Male gender, Prolactin level at diagnosis, and immediate postoperative PRL level were positively correlated with maximal tumor diameter (r=0.443, P=0.026; r=0.710, P<0.001; r=0.623, P=0.001). Maximal tumor diameter and PRL level at diagnosis were significantly higher in surgery group in comparison with non-surgery group (P=0.001, P=0.013, respectively). Macroprolactinoma is more prevalent in adolescents than adults. In adolescents with prolactinoma, girl is more prevalent, boys usually present with mass effect symptoms from macroprolactinoma. Male gender is in higher risk for macroadenoma more than female in adolescents with prolactinoma. Macroprolactinoma usually presents with panhypopituitarism. Given that diagnosis and prognosis may vary depending on the gender, we need to consider a more aggressive treatment in males. In addition, cocktail test for adolescents with prolactinoma is essential and adjustive hormone replacement is important to improve their quality of life.

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