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Updated: May 5, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Central precocious puberty secondary to postoperative craniopharyngioma: two case reports and a literature review
Ruyuan Zhu1, Luyao Wang1, Ling Zhao1
1Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China.
Insights
Craniopharyngioma surgery can rarely induce central precocious puberty (CPP) in children. Gonadotropin-releasing hormone analogue treatment effectively inhibited sexual development and bone age progression in these cases.
Area of Science:
- Pediatric Endocrinology
- Pediatric Neurosurgery
- Oncology
Background:
- Craniopharyngioma, a common pediatric intracranial tumor, typically presents with hormonal deficiencies, visual impairment, or increased intracranial pressure.
- While hormonal deficiencies are common, manifestations like precocious puberty (PP) are rare complications of craniopharyngioma.
Observation:
- Two pediatric patients diagnosed with craniopharyngioma developed central precocious puberty (CPP) postoperatively.
- Breast development was observed one month after surgery in one patient and 15 months after surgery in the other.
Findings:
- Treatment with gonadotropin-releasing hormone analogues (GnRHa) effectively reduced sex hormone levels and prevented significant bone age acceleration in both patients.
- This suggests GnRHa therapy can successfully manage CPP induced by craniopharyngioma surgery.
Implications:
- Craniopharyngioma surgery can induce central precocious puberty, necessitating vigilant monitoring.
- Long-term follow-up protocols for pediatric craniopharyngioma patients should include screening for CPP and timely GnRHa treatment if indicated.
Background:
Craniopharyngioma is a common intracranial tumour in children. Clinical manifestations are related to hypothalamic/pituitary deficiencies, visual impairment, and increased intracranial pressure. Defects in pituitary function cause shortages of growth hormone, gonadotropin, corticotropin, thyrotropin, and vasopressin, resulting in short stature, delayed puberty, feebleness, lethargy, polyuria, etc. However, manifestations involving precocious puberty (PP) are rare.
Case Report:
In both patients, surgical resection was performed after the diagnosis of craniopharyngioma, and breast development occurred postoperatively at one month in one patient and at one year and three months in the other patient. Central precocious puberty (CPP) was diagnosed via relevant examinations. Leuprorelin was injected subcutaneously every 28 days, and changes in height, weight, bone age, gonadal ultrasound and sex hormones were recorded. During the follow-up of the two children, the sex hormone levels were significantly reduced, and significant acceleration in bone age was not observed.
Conclusions:
CPP was induced by craniopharyngioma surgery, and treatment with gonadotropin-releasing hormone analogues (GnRHa) inhibited sexual development and bone age progression. More attention should be given to monitoring for CPP during long-term follow-up of craniopharyngiomas in the clinic.
