Saba, Leslie

Abstract Purpose Sellar and parasellar lesions in children have heterogeneous clinical presentations and variable endocrine morbidity. Population-based data describing endocrine outcomes across lesion types and management strategies remain limited. Methods We conducted a retrospective, population-based cohort study of patients aged 18 years or younger who were diagnosed with sellar or parasellar lesions between 1976 and 2021 in a multicounty region. Clinical presentation, lesion characteristics, management, and endocrine outcomes were abstracted from medical records. Associations were evaluated by lesion type, lesion size (< 10 mm vs. ≥10 mm), and management approach. Results Among 104 patients, endocrine abnormalities at diagnosis differed by lesion type (p = 0.0004) and were most frequent among patients with pituitary adenomas. Endocrine dysfunction at presentation was more common with lesions ≥ 10 mm than with lesions < 10 mm (74.2% vs. 49.2%; p = 0.0217). Post-treatment endocrine abnormalities were also more common with lesions ≥ 10 mm (64.5% vs. 13.1%; p < 0.0001). Surgical treatment was associated with a higher prevalence of post-treatment endocrinopathy, although this association may reflect lesion size, diagnosis, and treatment selection. Conclusions Endocrine morbidity was common in this population-based pediatric cohort and was associated with lesion type and size. Clinically relevant endocrine abnormalities also occurred in smaller lesions, supporting endocrine evaluation regardless of lesion size and the need for longitudinal surveillance in patients with sellar and parasellar disease.