Successful Surgical Removal of GH-secreting Adenoma in Early Childhood: Long-term Follow-up into Adulthood

This report provides novel clinical and biochemical data generated over 25 years of close follow-up of a 5-year, 5-month-old female who presented with excessive linear growth and had successful resection of a GH and prolactin-secreting pituitary adenoma. Postoperative pituitary function was consistently normal except for biochemical features of isolated partial GH deficiency documented up to 14 years after surgery. Postoperatively, the patient had minimal linear growth until she went through spontaneous pubertal changes, which resulted in a final adult height within the range of mid-parental estimate. She subsequently had 3 successful pregnancies yielding 3 healthy children. Bone age was advanced at diagnosis but was similar to chronological age throughout puberty and into adulthood. The unique features of this case include not only the successful resection of a GH-secreting adenoma in a prepubertal female but more importantly the inclusion of detailed clinical and biochemical data documenting partial GH deficiency postoperatively along with height and bone age measurements throughout adolescence and into adulthood. The case raises questions about the conundrum of the therapeutic use of GH in children who develop isolated partial deficiency of the hormone after successful treatment of gigantism without having a delay in bone age.