ESPE Abstracts

We present a monocentric cross-sectional study of 55 children referred between 2000 and 2020 for pituitary lesions, who underwent a complete pituitary function assessment. These data were compared to results obtained in a group of 295 adults carrying pituitary lesions undergoing a complete pituitary screening. Follow-up data was available for 50 children and 248 adults. The mean age at diagnosis in children was 12.2±3.7 years (range 2.1-17.9), while in adults was 48.7±15.5 years (range 18.0-89.7). In the pediatric group, there was a male preponderance compared to adults (69% vs 37%, P < 0.0001). The most frequent lesions among children were pituitary hypoplasia (31/55), Pituitary Stalk Interruption Syndrome (11/55) and expansive lesions (microadenomas or craniopharyngiomas: 8/55), while in adults the most frequent lesions were secreting microadenomas (56/295) or macroadenomas (52/295) and primary empty sellas (82/295). Secreting adenomas were significantly less represented in children compared to adults (7% vs 37%, P < 0.0001). In children, radiological findings were performed following endocrine work-up, mainly driven by poor growth or pubertal delay while in adults they were mostly incidental and preceded endocrine evaluation (90.9% vs 62%, P < 0.0001). Children presented with at least one pituitary deficit compared to adults (89.1% vs 48.8%, P < 0.0001) and this was homogeneous throughout years of examination. Even considering similar pituitary lesions such as primary empty sellas and small anterior pituitaries taken together, children with these lesions showed more frequently at least one pituitary deficiency compared to adults (94.1% vs 51.1%, P < 0.0001). GH deficiency was statistically more frequent in children (83.3% vs 14.8%, P <0.0001) and central hypothyroidism tended to be lower than in adults (10.9% vs 21.5%, P = 0.072), while hypogonadism, hypoadrenalism, diabetes insipidus and prolactin deficiency did not differ in prevalence between children and adults. During a median follow-up of 54.6 months [interquartile range 23.5 – 103.8], a similar risk of worsening of pituitary function was observed in children and adults (8.0% vs 15.7%, P = 0.156). To our knowledge, this is the first monocentric report aimed to analyze the differences between children and adults presenting with a pituitary lesion. Pituitary lesions in children are rarer than in adults, but present more likely with pituitary deficiencies and growth defects account for the vast majority of their presentations. At variance with adult patients, children with empty sellas and small anterior pituitaries typically present functional pituitary defects.