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Excessive growth in a child with craniopharyngioma and growth hormone deficiency
J M Wit1, A Schuitema-Dijkstra, S van Buul-Offers
1Department of Paediatrics, University Hospital for Children and Youth het Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands.
Insights
A craniopharyngioma tumor caused excessive growth in a child by potentially producing a growth factor. Tumor removal halted growth, suggesting a direct link between the tumor and the growth abnormality.
Area of Science:
- Pediatric Endocrinology
- Neuro-oncology
- Growth Disorders
Background:
- Craniopharyngiomas are rare tumors often affecting the pituitary gland and hypothalamus.
- Pediatric excessive growth can be caused by various endocrine and neoplastic conditions.
Observation:
- A 5-year-old boy presented with significant clumsiness and excessive growth.
- Diagnostic imaging revealed a large craniopharyngioma.
- Biochemical tests showed growth hormone deficiency, central hypothyroidism, hypocorticalism, elevated thyroxine-binding globulin, abnormal gonadotropin secretion, and mild hyperprolactinemia.
Findings:
- Following surgical removal of the craniopharyngioma, the patient's excessive growth ceased almost completely.
- Post-operative plasma insulin-like growth factor (IGF)-I levels were in the lower normal range.
- Plasma IGF-II levels decreased significantly after tumor resection.
Implications:
- The craniopharyngioma may have produced a specific growth factor responsible for the patient's excessive growth.
- Understanding the tumor's secretory function is crucial for managing growth abnormalities in pediatric oncology.
- This case highlights the complex endocrine disturbances associated with craniopharyngiomas.
Abstract:
In a 5-year-old boy presenting with clumsiness and excessive growth, a large craniopharyngioma was diagnosed. Biochemically, there was a deficiency of growth hormone, a hypothalamic hypothyroidism and hypocorticalism, a thyroxine binding globulin elevation, an abnormal gonadotropin secretion and a mild hyperprolactinaemia. After removal of the tumour growth stopped almost completely. Plasma insulin-like growth factor (IGF)-I was in the lower normal range. Plasma IGF-II decreased after tumour removal. It is speculated that the tumour produced a growth factor causing excessive growth.