Craniopharyngioma and potential endocrine sequelae in childhood

Abstract

The postoperative course of 16 children undergoing surgery for craniopharyngioma (CRA) was reviewed for ne¬uroendocrine dysfunctions. All had an attempt at radical or partial surgical resection of the tumor with no radio or chemotherapy. Antropometric measurements, pubertal staging, neuroendocrine evaluation (GH provocative testing, Thyroid function tests, HPA axis activity, salt-water balance, serum prolactine values) were made for assessment of endocrine course. Hypopituitarism with multiple hormone deficiency in vary combination was found in all of the patients ( 100 % ). We observed GH-deficiency 81.25%, hypothalamo-pituitary-adrenal axis impairment 75%, hypophysial hypothyroidism 68.75%, complete or partial central diabetes insipidus 56.25%, short stature 56.25%, obesity 50%, hyperprolactinemia 18.75%, transient hypodypsic hypernatremic syndrome 18.75%, complete puberty precocious 12.5% of patients. None of them had isolated hormone deficiency. Eleven of 16 patients had deficits of four or mo¬re neuroendocrine dysfunction. 5/x.ouf of 13 GH-deficient children showed normal growth pattern (normally gro¬wing GH-deficient children ). Obesity was more prominent in normally growed patients then the patients with short stature. Our data showed that endocrine sequelae is an inevitable result of CRA. When possible full evaluation of pitu¬itary function should be performed; the minimum preoperative evaluation must include testing for and treatment of ACTH-adrenal insufficiency and diabetes insipidus, hypodipsia-hypernatremia associations.