GIANT SILENT CORTICOTROPIC ADENOMA IN AN ADOLESCENT: A CASE REPORT

Pituitary tumors in children and adolescents are dominated by craniopharyngiomas (80-90%) followed by adenomas. Silent pituitary adenomas in children and adolescents are rare represent only 4-6% of all adenomas. We present the case of a silent giant corticotropic adenoma revealed by pituitary tumoral syndrome in an adolescent. This is a 17-year-old patient operated for an invasive interstellar and suprasellar mass of 34x63x42 mm revealed by intense headaches, blindness in the left eye and a significant decrease in visual acuity in the right eye evolving for 1 month in a context of growth retardation for 4 years, without signs of associated pituitary hormonal hypersecretion. immunohistochemistry had concluded to a corticotropic adenoma. control hypothalamic-pituitary MRI showed persistence of the sellar and suprasellar mass of 33x31x34 mm. The patient had been referred for revision surgery. Silent adenomas are rare in childhood and adolescence let alone giant corticotropic silent adenomas. They are associated with significant morbidity due to their location, their mass effect and / or their interference with normal pituitary hormonal functions. Surgical treatment remains the first-line treatment. Long-term follow-up remains essential to detect recurrence and to manage the various pituitary deficits.