Clinical Course of Non-Functional Pituitary Microadenoma in Children: A Single Center Experience: Supplemental Table

Context: Pituitary lesions consistent with microadenomas are increasingly discovered by magnetic resonance imaging (MRI). Sparse data are available on the long-term clinical and imaging course of such lesions in children. Objective: The aim of this study was to define the clinical and imaging course of pituitary lesions representing or possibly representing non-functioning microadenomas in children to guide clinical management. Design: Retrospective observational study. Methods: The clinical data warehouse at a tertiary care academic children’s hospital was queried with the terms “pituitary” AND “microadenoma”, and “pituitary” AND “incidentaloma”. The electronic health records of the identified subjects were reviewed to extract data on the clinical and imaging course. Results: A total of 78 children with non-functioning pituitary lesions incidentally discovered during clinical care, of which 44 (56%) were reported as presumed or possible microadenomas. In the children with microadenoma (median age 15 years, IQR 2), majority (70%) underwent imaging for non-endocrine symptoms, the commonest being headache (n = 16, 36%). No significant increase in the size of the microadenoma or cysts or worsening of pituitary function was seen over the average clinical follow-up of 4.5 +/- 2.6 years. Four cases of drug-induced hyperprolactinemia resolved with discontinuation of the offending medication. Conclusions: Asymptomatic pituitary lesions representing cysts, microadenomas or possible microadenomas follow a benign course in children. In the absence of new endocrine or visual symptoms, repeat MRI may not be needed, and if performed, no sooner than a year. When possible, it is prudent to discontinue hyperprolactinemia inducing medications prior to imaging.