Puberty and plexiform neurofibroma tumor growth in patients with neurofibromatosis type I

J Pediatr. 2014 Mar;164(3):620-4. doi: 10.1016/j.jpeds.2013.10.081. Epub 2013 Dec 8.

Abstract

Objective: To assess the relationship between pubertal progression and change in plexiform neurofibroma (PN) burden over time in pediatric and young adult patients with neurofibromatosis type 1 and PNs.

Study design: Analyses accounted for sex, age, race, and chemotherapy. Forty-one patients with neurofibromatosis type 1 (15 female and 26 male patients) were studied at the National Institutes of Health. Tanner stage, testosterone, progesterone, estradiol, insulin-like growth factor -1, luteinizing hormone, and follicle-stimulating hormone were assessed. Tumor volume was measured using magnetic resonance imaging and lesion detection software developed locally. Patients were divided into 2 groups based on whether they were actively progressing through puberty (n = 16) or were peripubertal (n = 25) and were followed for an average of 20 months. Tumor growth rates in the puberty and peripubertal group were analyzed for a subset of patients.

Results: There was no statistically significant difference in tumor burden change over time (cm(2)/kg per month) between the pubertal and peripubertal groups (-0.16 ± 0.34 vs 0.03 ± 1.8, P = .31) and in the PN growth rates before and during puberty (P = .90). Change in tumor volume/patient weight/time did not correlate with testosterone change/time in males or estradiol change/time in females.

Conclusion: These findings support that hormonal changes of puberty do not accelerate PN growth. Additional long-term follow-up of patients is necessary to further characterize the interaction between puberty and tumor growth.

Trial registration: ClinicalTrials.gov NCT00924196.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Child
  • Estrogens / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Follow-Up Studies
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Luteinizing Hormone / blood
  • Magnetic Resonance Imaging
  • Male
  • Neurofibroma, Plexiform / pathology*
  • Neurofibromatosis 1 / pathology*
  • Progesterone / blood
  • Prospective Studies
  • Puberty*
  • Testosterone / blood

Substances

  • Estrogens
  • Testosterone
  • Progesterone
  • Insulin-Like Growth Factor I
  • Luteinizing Hormone
  • Follicle Stimulating Hormone

Associated data

  • ClinicalTrials.gov/NCT00924196