GH Replacement in Children and Adolescent following Surgery for Hypothalamic-Pituitary Neoplasia

Growth hormone deficiency (GHD) is one the most common and early endocrine complications in children and adolescent undergoing surgery for hypothalamic-pituitary neoplasm. Etiological factors include tumor mass effect, hypothalamic/pituitary damage caused by surgery and/or radiation therapy. The diagnosis and treatment of patients with brain tumors is extremely complex and requires close monitoring by a multidisciplinary expert team that must define the most appropriate treatment type and timing according to patient and tumor features, including GH replacement treatment (GH-rT), through the harmonization of the criteria used to define when the neoplastic disease is stable and when and how to start and stop GH-rT, in order to improve patient outcome and quality of life. Despite several proofs of safety, GH-rT remains a matter of debate.