Résumé
Giant pituitary tumors secreting growth hormone in children and adolescents
Pr F. CHENTLIa, Dr M. HADDADa, Dr K. DAFFEURa, Pr D. MESKINEb, Pr S. AZZOUGa, Pr MA. AMANIc
a Faculté de Médecine d'Alger, CHU Bab El Oued, Service d'Endocrinologie et Métabolisme, Alger ; b Faculté de Médecine, Hôpital Bologhine, Service d'Endocrinologie et Métabolisme, Alger ; c Faculté de Médecine d'Oran, Service d'Endocrinologie et Diabétologie, Oran
Introduction: Pituitary tumors secreting growth hormone (GH) are relatively rare in children and adolescents. Giant ones (maximal diameter≥4cm) are even rarer. We aimed to analyze their frequency and their complications in Algerian population.
Methods: it is a retrospective and multicenter study over a long period of time (1980-2013) which aimed to collect giant pituitary tumors secreting GH in order to analyze their characteristics.
Results: Among 31 well proved somatotroph adenomas observed in children and adolescents (≤20 years old) or in older subjects with lack of pubertal development, we found 12 giant tumors =38.7%. Median age at diagnosis was 22.4 years old (13-30). 8/12 suffered from gigantism (66.6%) other had acromegaly. Median tumor diameter=60.5mm (40-100). Median GH=570ng/ml (30-1430). All had moderate to severe visual troubles. 2 or more pituitary deficits were observed in 4 cases=33.3%, hydrocephalus=8 cases (66.6%), frontal syndrome=3=25% and epilepsy n=1=8.3%.
Conclusion: in our population giant tumors secreting GH are frequent and diagnosed late even in those with gigantism which explains the high frequency of severe and life threatening neurological complications.
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