Incidental Pituitary Cysts in Children: Does Growth Hormone Treatment Affect Cyst Size?

INTRO Children with growth hormone deficiency often undergo MRI of the brain prior to growth hormone treatment. In some cases, pituitary cysts are discovered. The response of pituitary cysts to growth hormone treatment is not known. METHODS A retrospective chart review was performed of all children with pituitary cysts on MRI over a 20-year period. Records and images were reviewed, and results analyzed with descriptive statistics. Children with pituitary cysts who received growth hormone treatment were compared to those without. RESULTS We identified 109 children with pituitary cysts, 24 of whom had growth hormone deficiency and were treated with growth hormone therapy. Average age was 8.6 ±5.1 years. Children whose initial MRI scan was to evaluate growth hormone deficiency were more commonly male and white, non-Hispanic compared to scans for other indications (male 18/24 v. 35/85, p=0.003; white 23/24 v. 58/85, p=0.004). Among patients who had growth hormone treatment, 12 had follow up MRI scans (mean 12.5 months between scans). Six had no change in cyst size and 6 had decrease in cyst size. We observed no difference in the likelihood of cyst growth between those who received GH and those who did not (0/12 cysts with GH v. 1/15 cysts without GH showed growth at follow up). No patient had neurological deficits attributable to the pituitary cyst at any time. CONCLUSION In a single-institution, retrospective study, we show no evidence of growth or change of pituitary cyst in response to growth hormone therapy.