{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:46:05Z","timestamp":1762101965540},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:p>Primary neoplasms of the pituitary gland are uncommon in children. Physiological enlargement of the gland, however, is universal and can sometimes be confused with a tumor. Due to widespread availability of MR imaging, the number of children referred to pediatric neurosurgeons with an enlarged pituitary associated with nonspecific symptoms, most commonly headache, is increasing. In this review, the authors illustrate two common causes of pituitary enlargement in children, namely physiological hypertrophy of puberty, more commonly seen in females, and secondary hyperplasia caused by hypothyroidism. The importance of early and accurate diagnosis, without recourse to extensive endocrine investigations or inappropriate surgery, is underscored.<\/jats:p>","DOI":"10.3171\/2011.2.peds10509","type":"journal-article","created":{"date-parts":[[2016,12,27]],"date-time":"2016-12-27T13:07:55Z","timestamp":1482844075000},"page":"510-515","source":"Crossref","is-referenced-by-count":12,"title":["Nonneoplastic enlargement of the pituitary gland in children"],"prefix":"10.3171","volume":"7","author":[{"given":"Kristian","family":"Aquilina","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Frenchay Hospital, Bristol, United Kingdom; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick A.","family":"Boop","sequence":"additional","affiliation":[{"name":"Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0070510","series-title":"Headache","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1046\/j.1526-4610.1998.3810782.x","article-title":"Headache associated with pituitary adenomas","volume":"38","author":"Abe","year":"1998"},{"key":"b2-0070510","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/s11102-008-0149-8","article-title":"Clinical profile and long term follow up of children and adolescents with prolactinomas","volume":"12","author":"Acharya","year":"2009"},{"key":"b3-0070510","series-title":"J Clin Endocrinol Metab","first-page":"1789","article-title":"The dominant role of increased intrasellar pressure in the pathogenesis of hypopituitarism, hyperprolactinemia, and headaches in patients with pituitary adenomas","volume":"85","author":"Arafah","year":"2000"},{"key":"b4-0070510","series-title":"Arch Pathol Lab Med","first-page":"360","article-title":"Prolactin cells in the human pituitary. A quantitative immunocytochemical analysis","volume":"106","author":"Asa","year":"1982"},{"issue":"4 Suppl","key":"b5-0070510","series-title":"J Neurosurg","first-page":"413","article-title":"Primary hypothyroidism in a 12-year-old girl with a suprasellar pituitary mass: rapid regression after thyroid replacement therapy: case report","volume":"102","author":"Ashley","year":"2005"},{"key":"b6-0070510","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"3175","DOI":"10.1001\/jama.1989.03430220098038","article-title":"Reversible suprasellar pituitary mass secondary to hypothyroidism","volume":"262","author":"Atchison","year":"1989"},{"key":"b7-0070510","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1148\/131.1.99","article-title":"Normal variants of the sella turcica","volume":"131","author":"Bruneton","year":"1979"},{"key":"b8-0070510","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1046\/j.1365-2265.2003.01748.x","article-title":"Clinical presentation and outcome of pituitary adenomas in teenagers","volume":"58","author":"Cannav\u00f2","year":"2003"},{"key":"b9-0070510","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1148\/radiology.144.1.7089241","article-title":"Regions of low density in the contrast-enhanced pituitary gland: normal and pathologic processes","volume":"144","author":"Chambers","year":"1982"},{"key":"b10-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"3009","DOI":"10.1210\/jcem.86.7.7649","article-title":"Normal pituitary hypertrophy as a frequent cause of pituitary incidentaloma: a follow-up study","volume":"86","author":"Chanson","year":"2001"},{"key":"b11-0070510","series-title":"Arch Pediatr Adolesc Med","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1001\/archpedi.1996.02170310057010","article-title":"Pituitary enlargement on magnetic resonance imaging in congenital hypothyroidism","volume":"150","author":"Desai","year":"1996"},{"key":"b12-0070510","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1148\/radiology.178.1.284-b","article-title":"MR imaging of physiologic pituitary gland hypertrophy in adolescence","volume":"178","author":"Doraiswamy","year":"1991"},{"key":"b13-0070510","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1159\/000028649","article-title":"Primary hypothyroidism mimicking a pituitary macroadenoma","volume":"28","author":"Ehirim","year":"1998"},{"key":"b14-0070510","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1148\/radiology.174.3.2305049","article-title":"Pituitary gland: MR imaging of physiologic hypertrophy in adolescence","volume":"174","author":"Elster","year":"1990"},{"key":"b15-0070510","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1007\/s00247-008-1012-9","article-title":"Primary hypothyroidism mimicking a pituitary macroadenoma: regression after thyroid hormone replacement therapy","volume":"39","author":"Eom","year":"2009"},{"key":"b16-0070510","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"354","DOI":"10.3171\/2008.8.JNS08805","article-title":"Significant headache improvement after transsphenoidal surgery in patients with small sellar lesions. Clinical article","volume":"110","author":"Fleseriu","year":"2009"},{"key":"b17-0070510","series-title":"Am J Med","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/0002-9343(87)90911-9","article-title":"Patients with primary hypothyroidism presenting as prolactinomas","volume":"83","author":"Grubb","year":"1987"},{"key":"b18-0070510","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1007\/BF01387318","article-title":"Precocious puberty with pituitary gland hyperplasia: two cases in one family","volume":"26","author":"Gupta","year":"1996"},{"key":"b19-0070510","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1148\/radiology.172.1.2740500","article-title":"Development and aging of brain midline structures: assessment with MR imaging","volume":"172","author":"Hayakawa","year":"1989"},{"key":"b20-0070510","series-title":"Horm Res","first-page":"61","article-title":"Primary hypothyroidism in a child mimicking a pituitary macroadenoma","volume":"63","author":"Hopper","year":"2005"},{"key":"b21-0070510","series-title":"Pathol Res Pract","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/S0344-0338(88)80028-1","article-title":"Fine structural cytology and immunohistochemistry of the non-adenomatous pars distalis of the human pituitary","volume":"183","author":"Horvath","year":"1988"},{"key":"b22-0070510","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1023\/A:1009952930425","article-title":"Pituitary hyperplasia","volume":"1","author":"Horvath","year":"1999"},{"key":"b23-0070510","series-title":"Lab Invest","first-page":"511","article-title":"Propylthiouracyl-induced hypothyroidism results in reversible transdifferentiation of somatotrophs into thyroidectomy cells. A morphologic study of the rat pituitary including immunoelectron microscopy","volume":"63","author":"Horvath","year":"1990"},{"key":"b24-0070510","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s11102-005-3281-8","article-title":"Pituitary hyperplasia secondary to primary hypothyroidism: a case report and review of the literature","volume":"8","author":"Joshi","year":"2005"},{"key":"b25-0070510","series-title":"J Clin Endocrinol Metab","first-page":"1135","article-title":"Pituitary adenomas in childhood and adolescence","volume":"79","author":"Kane","year":"1994"},{"key":"b26-0070510","series-title":"Expert Rev Neurother","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1586\/14737175.8.4.563","article-title":"Pituitary tumors in childhood: update of diagnosis, treatment and molecular genetics","volume":"8","author":"Keil","year":"2008"},{"key":"b27-0070510","series-title":"Endocr Pract","doi-asserted-by":"publisher","first-page":"29","DOI":"10.4158\/EP.12.1.29","article-title":"Pituitary enlargement in patients with primary hypothyroidism","volume":"12","author":"Khawaja","year":"2006"},{"key":"b28-0070510","series-title":"AJNR Am J Neuroradiol","first-page":"1213","article-title":"CT and MR evaluation of the brain in patients with anorexia nervosa","volume":"12","author":"Kornreich","year":"1991"},{"key":"b29-0070510","series-title":"Arch Pathol Lab Med","first-page":"562","article-title":"Prolactin-producing pituitary adenoma in a male-to-female transsexual patient with protracted estrogen administration. A morphologic study","volume":"118","author":"Kovacs","year":"1994"},{"key":"b30-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"4385","DOI":"10.1210\/jcem.84.12.6240","article-title":"Pediatric pituitary adenomas","volume":"84","author":"Kunwar","year":"1999"},{"key":"b31-0070510","series-title":"Clin Imaging","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/0899-7071(91)90078-A","article-title":"MR imaging of pituitary hypertrophy due to juvenile primary hypothyroidism: a case report","volume":"15","author":"Kuroiwa","year":"1991"},{"key":"b32-0070510","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"212","DOI":"10.3171\/PED\/2008\/2\/9\/212","article-title":"Rapid progression of hypothyroidism-related pituitary hyperplasia. Case report","volume":"2","author":"Lee","year":"2008"},{"key":"b33-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1210\/jcem-43-4-775","article-title":"Puberty in girls: correlation of serum levels of gonadotropins, prolactin, androgens, estrogens, and progestins with physical changes","volume":"43","author":"Lee","year":"1976"},{"key":"b34-0070510","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1001\/archneur.61.5.721","article-title":"Pituitary volume and headache: size is not everything","volume":"61","author":"Levy","year":"2004"},{"key":"b35-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1210\/jcem-71-2-505","article-title":"In vivo assessment of pituitary gland volume with magnetic resonance imaging: the effect of age","volume":"71","author":"Lurie","year":"1990"},{"key":"b36-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1210\/jc.2002-021730","article-title":"Children with classic congenital adrenal hyperplasia have decreased amygdala volume: potential prenatal and postnatal hormonal effects","volume":"88","author":"Merke","year":"2003"},{"key":"b37-0070510","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1227\/00006123-199502000-00004","article-title":"Pediatric pituitary adenomas","volume":"36","author":"Mindermann","year":"1995"},{"key":"b38-0070510","series-title":"Cancer Treat Res","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/978-1-4615-6355-6_5","article-title":"Approach to the incidentally discovered pituitary mass","volume":"89","author":"Molitch","year":"1997"},{"key":"b39-0070510","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/BF00342982","article-title":"A parallel study of the roentgen anatomy of the sella turcica and the histopathology of the pituitary gland in 205 autopsy specimens","volume":"21","author":"Muhr","year":"1981"},{"key":"b40-0070510","series-title":"Headache","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1111\/j.1526-4610.2006.00539.x","article-title":"Headaches associated with Rathke's cleft cyst","volume":"46","author":"Nishioka","year":"2006"},{"key":"b41-0070510","series-title":"Int J Clin Pract","first-page":"409","article-title":"Primary hypothyroidism with hyperprolactinaemia and pituitary enlargement mimicking a pituitary macroadenoma","volume":"51","author":"Ozbey","year":"1997"},{"key":"b42-0070510","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3171\/jns.1994.80.2.0209","article-title":"Pituitary adenomas in childhood and adolescence. Results of transsphenoidal surgery","volume":"80","author":"Partington","year":"1994"},{"key":"b43-0070510","series-title":"J Clin Endocrinol Metab","first-page":"1170","article-title":"Precocious puberty in girls: pituitary height as an index of hypothalamo-pituitary activation","volume":"75","author":"P\u00e9rignon","year":"1992"},{"key":"b44-0070510","series-title":"AJNR Am J Neuroradiol","first-page":"411","article-title":"CT appearance of the adolescent and preadolescent pituitary gland","volume":"4","author":"Peyster","year":"1983"},{"key":"b45-0070510","series-title":"J Adolesc Health Care","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0197-0070(84)80244-2","article-title":"Galactorrhea in the adolescent","volume":"5","author":"Rohn","year":"1984"},{"key":"b46-0070510","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1002\/mrm.1910070305","article-title":"Quantitative magnetic resonance imaging of estradiol-induced pituitary hyperplasia in rats","volume":"7","author":"Rudin","year":"1988"},{"key":"b47-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1210\/jcem.82.3.3796","article-title":"MRI-demonstrable regression of a pituitary mass in a case of primary hypothyroidism after a week of acute thyroid hormone therapy","volume":"82","author":"Sarlis","year":"1997"},{"key":"b48-0070510","series-title":"Arch Pathol Lab Med","first-page":"499","article-title":"Pituitary gland in hypothyroidism. Histologic and immunocytologic study","volume":"109","author":"Scheithauer","year":"1985"},{"key":"b49-0070510","series-title":"Mayo Clin Proc","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1016\/S0025-6196(12)64976-3","article-title":"Effects of estrogen on the human pituitary: a clinicopathologic study","volume":"64","author":"Scheithauer","year":"1989"},{"key":"b50-0070510","series-title":"Mayo Clin Proc","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/S0025-6196(12)60946-X","article-title":"The pituitary gland in pregnancy: a clinicopathologic and immunohistochemical study of 69 cases","volume":"65","author":"Scheithauer","year":"1990"},{"key":"b51-0070510","series-title":"J Comput Assist Tomogr","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1097\/00004728-199001000-00006","article-title":"Height of normal pituitary gland on MR imaging: age and sex differentiation","volume":"14","author":"Suzuki","year":"1990"},{"key":"b52-0070510","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1148\/133.2.385","article-title":"The computed tomographic appearance of the normal pituitary gland and pituitary microadenomas","volume":"133","author":"Syvertsen","year":"1979"},{"key":"b53-0070510","series-title":"Adv Tech Stand Neurosurg","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/978-3-7091-6898-1_1","article-title":"The classification and molecular biology of pituitary adenomas","volume":"22","author":"Thapar","year":"1995"},{"key":"b54-0070510","series-title":"AJNR Am J Neuroradiol","first-page":"551","article-title":"MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium","volume":"18","author":"Tsunoda","year":"1997"},{"key":"b55-0070510","series-title":"Fertil Steril","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/S0015-0282(16)47307-3","article-title":"Regression of a pituitary adenoma following levothyroxine therapy of primary hypothyroidism","volume":"40","author":"Valenta","year":"1983"},{"key":"b56-0070510","series-title":"Cephalalgia","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1046\/j.1468-2982.2001.00265.x","article-title":"Rathke's cleft cyst as a secondary cause of headache: a case report","volume":"21","author":"Ward","year":"2001"},{"key":"b57-0070510","series-title":"Arch Pathol Lab Med","doi-asserted-by":"publisher","first-page":"77","DOI":"10.5858\/2008-132-77-PPA","article-title":"Pediatric pituitary adenomas","volume":"132","author":"Webb","year":"2008"},{"key":"b58-0070510","series-title":"AJNR Am J Neuroradiol","first-page":"717","article-title":"Measurement of pituitary gland height with MR imaging","volume":"6","author":"Wiener","year":"1985"},{"key":"b59-0070510","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1210\/jcem-57-2-283","article-title":"Visual field defects and pituitary enlargement in primary hypothyroidism","volume":"57","author":"Yamamoto","year":"1983"},{"key":"b60-0070510","series-title":"Ann Afr Med","doi-asserted-by":"publisher","first-page":"77","DOI":"10.4103\/1596-3519.55676","article-title":"Description of the normal variants of the anatomical shapes of the sella turcica using plain radiographs: experience from Sokoto, Northwestern Nigeria","volume":"7","author":"Zagga","year":"2008"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/7\/5\/article-p510.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/7\/5\/article-p510.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/7\/5\/article-p510.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T15:36:40Z","timestamp":1681573000000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/7\/5\/article-p510.xml"}},"subtitle":["A review"],"short-title":[],"issued":{"date-parts":[[2011,5]]},"references-count":60,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2011.2.peds10509","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5]]}}}