Clinical presentation and outcome of XXXX in teenagers.

@entity1 @entity851 @entity2013 @entity5 @entity4090 @entity4614 @entity977 @entity10 @entity21696
OBJECTIVE: @entity977 rarely occur in childhood and adolescence, but their mass effect and endocrine abnormalities can compromise both quality and length of life. In this study we evaluated the symptoms at onset and the long-term consequences induced in teenagers by functioning or nonfunctioning @entity977 . DESIGN AND @entity1 : Clinical, biochemical and neuroradiological data of 44 young @entity1 (12 males and 32 females, aged 16.3 +/- 1.9 years at diagnosis) with @entity977 were evaluated retrospectively at baseline and after therapy. @entity1 underwent surgery, radiotherapy and/or medical treatment depending on clinical history and endocrine secretion of the @entity5 . Follow-up ranged from 8 to 252 months (median 55 months). MEASUREMENTS: Baseline and dynamic pituitary function were evaluated in all cases at diagnosis and after treatments. Magnetic resonance imaging (MRI) or computed tomography (CT) scan were performed before therapy and during follow-up. Hormone levels were measured using commercial radioimmunologic or immunoradiometric methods. RESULTS: Pituitary macroadenomas (group 1) or microadenomas (group 2) were found in 61% and 39% of cases, respectively. Overall, 68% were @entity4090 -secreting, 7% GH-secreting, 5% ACTH-secreting and 20% nonfunctioning. The most frequent symptoms at onset were oligoamenorrhoea (62%) and @entity21696 (59%) in the @entity1 , and @entity10 (58%) in the @entity1 . Pubertal development was delayed in 12/27 (44%) cases with macroadenoma. @entity851 was observed in 4/44 (9%) @entity1 (3 in group 1 and 1 in group 2). At diagnosis, @entity4614 was detected in 10/27 (37%) @entity1 with macroadenoma. Surgery alone cured 4/18 (22%) and 4/9 (44%) @entity1 in group 1 and group 2, respectively. Adjuvant therapies (second surgery and/or radiotherapy and/or medical treatment) cured the disease in 2/13 (15%) @entity1 with macroadenoma and allowed a persistent normalization in other 4/13 (31%) and 2/4 (50%) cases in group 1 and group 2, respectively. Medical treatment alone cured 2/9 (22%) @entity1 with @entity4090 -secreting macroadenoma and normalized @entity4090 levels in another six (66%) with @entity2013 and in 2/7 (28%) @entity1 with @entity2013 . CONCLUSION: Delay of growth was rarely observed in teenagers with @entity977 . At the onset of the disease, many @entity1 complained of oligoamenorrhoea and @entity21696 , while @entity10 and delay of pubertal development were the symptoms more frequently referred by @entity1 . Surgery alone was effective in a minority of @entity1 and adjuvant therapies were helpful to obtain the remission of the disease in many cases. In @entity1 with @entity4090 -secreting @entity977 , medical treatment, both as first choice or as adjuvant therapy, normalizes serum @entity4090 levels in 14/27 (52%) cases.
