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Endocrine and growth features in childhood craniopharyngioma: a mono-institutional study
Eliana Di Battista1, Arturo Naselli, Sara Queirolo
1Auxoendocrinological Centre, Paediatric Department, University of Genoa, School of Medicine, Italy.
Insights
Children with craniopharyngioma often experience pituitary deficiencies and varied growth patterns post-treatment. Growth hormone (GH) deficit is common, requiring therapy, but some children achieve normal growth without GH.
Area of Science:
- Pediatric Endocrinology
- Pediatric Oncology
- Neuroendocrinology
Background:
- Craniopharyngioma is a rare brain tumor affecting the pituitary gland and surrounding structures.
- Endocrine dysfunction and growth disturbances are common complications in children with craniopharyngioma.
Purpose of the Study:
- To evaluate the growth and endocrine outcomes in pediatric patients with craniopharyngioma.
- To analyze the long-term effects of treatment on pituitary function and growth patterns.
Main Methods:
- Retrospective review of 32 pediatric patients treated for craniopharyngioma between 1976 and 2004.
- Analysis of presenting symptoms, endocrine disorders, and post-treatment pituitary hormonal deficiencies.
Main Results:
- Headache, nausea, vomiting, and visual impairment were common presenting symptoms.
- Endocrine disorders included polyuria, polydipsia, growth failure, precocious puberty, and obesity.
- All patients developed anterior and posterior pituitary deficiencies post-surgery, with growth hormone deficit (GHD) being frequent, necessitating hormone replacement therapy.
- Ten patients had hypothalamic involvement, often leading to obesity, hyperinsulinism, and hyperphagia.
Conclusions:
- Craniopharyngioma treatment in children frequently results in panhypopituitarism.
- Growth patterns in these patients are highly variable, with some achieving normal growth despite GHD.
Objective:
To evaluate growth and endocrine features in children with craniopharyngioma who were treated and followed up by a single institution between 1976 and 2004.
Patients:
The records of 32 children, 18 males and 14 females, were evaluated. The mean follow-up period was 6.3 years.
Results:
At presentation, the most common symptoms were headache, nausea and vomiting, visual impairment, and neurological changes. Some patients presented signs or symptoms of isolated or combined endocrine disorder (five polyuria and polydipsia, five growth failure, two precocious puberty, eight obesity or overweight). After tumour treatment, multiple pituitary hormonal deficiencies, especially growth hormone (GH) deficit (GHD) were found and required hormonal replacement therapy. Eight children grew normally without GH despite GHD. Hypothalamic involvement was observed in ten patients; obesity was frequent and was often associated with hyperinsulinism and hyperphagia.
Conclusion:
Anterior and posterior pituitary deficiencies following surgery are present in all patients. The growth pattern is heterogeneous.
