SUN-041 Comparison of Clinical Characteristics, Metabolic Parameters, and Treatment Outcomes of Pediatric Prolactinoma: A 10-Year Retrospective Study

Abstract Disclosure: S. Cholekho: None. H. Tan: None. Y. Liu: None. N. Chand: None. S. Zhang: None. Background: Prolactinoma, a rare pituitary tumor in pediatric populations, represents 2% to 6% of all intracranial neoplasms and exhibits distinct clinical and hormonal profiles compared to adult cases. It often poses unique diagnostic and therapeutic challenges, particularly in terms of tumor size, hormone dynamics, and long-term treatment outcomes. Objective: To compare the clinical characteristics, hormonal parameters, metabolic profiles, and treatment outcomes of pediatric prolactinoma. Methods: This retrospective study included 83 pediatric patients diagnosed with prolactinoma at the Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, from January 2015 to December 2024. Clinical manifestations, tumor size, and prolactin (PRL) levels were compared between males (27 cases, 32.5%) and females (56 cases, 67.5%). Hormonal profiles and anthropometric data were recorded at baseline, tumor size was measured before and after treatment. Treatment modalities included dopamine agonists, surgery, and adjunctive therapies, and their effectiveness was evaluated. Results: The cohort had a median age at diagnosis of 16 years. The most common presenting symptoms in females were menstrual irregularities (26.8%) and amenorrhea (13%), with primary amenorrhea (8.9%) and secondary amenorrhea (14.3%). In males, the predominant symptoms were visual disturbances (40.8%) and headache (18.5%). The median maximal tumor diameter was 21.5 mm (9,40) with significantly larger tumors in males 34.3 mm (24,42) compared to females 9 mm( 8,15).Macroadenomas were the most common tumor type (56.8%), and giant adenomas were observed in 12.3% of cases. Baseline median PRL levels were significantly higher in males 2,221 ng/mL,(470-4,700) compared to females 190 ng/mL (60.3,482) (p<0.05).Median post-treatment PRL levels showed significant reductions: Overall: 55.05 ng/mL (28.7,148),Males: 61.2 ng/mL (30,148),Females: 48.9 ng/mL (21.2,95.9). Dopamine agonists were the primary treatment modality, with surgical intervention required in 20% of cases, particularly for large or dopamine agonist-resistant tumors. Males had a significantly higher surgical requirement (48.2%), often due to the presence of macroadenomas or giant adenomas. Conclusion: Macroprolactinoma was the most common type of prolactinoma in pediatric patients in our study. Males exhibited larger tumors, higher baseline prolactin levels, and a greater likelihood of requiring surgical intervention. Dopamine agonist therapy was highly effective for tumor volume reduction and prolactin normalization, though macroadenomas posed greater therapeutic challenges and increased recurrence risks. These findings underscore the importance of early diagnosis, individualized treatment strategies, and long-term follow-up to optimize patient outcomes. Presentation: Sunday, July 13, 2025