ESPE Abstracts

Introduction: Lesional hypothalamic obesity is most frequently attributable to craniopharyngiomas. The aim of our work is to describe the modalities of occurrence of this complication in a series of 27 children with craniopharyngioma followed in our center. We carried out a descriptive retrospective study of 27 cases of craniopharyngioma in children followed in the endocrinology department of the CPMC over a period of 16 years.

Results: We found 6 cases of hypothalamic obesity called group 1 and 13 patients of normal weight called group 2, with 08 patients lost to follow-up. Group 1 was younger at diagnosis, with an average age of 6 years and 7 months, while the average age of group 2 was 8 years and 4 months. A clear male predominance in group 1 whereas the sex ratio of the second group was 1: 1. The initial BMI was correct in the majority of patients in all groups; varying between -1DS to + 1DS, only one case presented a BMI between +2 and +3 DS in group 1. Hypothalamic-pituitary MRI revealed a purely suprasellar site lesion in 66.7% of patients in group 1; and in group 2 the suprasellar and suprasellar lesion had predominated with 69.2% and the purely suprasellar lesions were only represented at 15.4%. The size of the lesion was in 50% of cases between 20 and 40 mm in the patients of group 1 while the lesions objectified in the second group were larger because in 46.2% their dimensions varied from 40 to 60 mm. The treatment consisted of first-line so-called total excisional surgery in all patients in group 1, and complementary conformational radiotherapy and yttrium. The average radiation dose was 53.4 Gy In group 1 The BMI at the last check-up improved for only one case, the other patients had a BMI of between +2 and +3 DS, while the BMI of group 2 was correct.

Conclusion: The prevalence of hypothalamic obesity in our series is in line with the literature. The patients in group 1 were younger at diagnosis compared to group 2. They also presented with suprasellar developing craniopharyngiomas in 66.5% against only 15.3% in group 2.surgical management was less conservative in group 1 or first-line resection, considered to be complete, was performed in all patients. fact known as a risk factor for hypothalamic injury. In group 2 only 38.4% benefited from a surgical excision which was considered partial.