ESPE Abstracts

Background: The craniopharyngioma is a non-endocrine tumor, developed along the infundibulo-pituitary axis, from the third ventricle to sphenoid, histologically benign but locally invasive. It is a tumor with serious complications because of its location, its considerable potential for extension, its tendency to recur, and its adhesions to neighbouring structures. Our aim is to assess hormonal profile, neuro-ophthalmological and metabolic complications at the diagnosis of craniopharyngiomas in children.

Patients and methods: It is a multicentre Cross-sectional descriptive study in the town of Oran, with prospective and retrospective data collection. MRI, hormonal, biochemical and ocular tests, made the diagnosis. Data entry and analysis were performed with CDC Epi Info version 6 (USA), SPSS 20, Statistica10.

Results: In our study, we collected 35 non-adenomatous tumours in children (age ≤15 years), among them 13 craniopharyngiomas (37.1%), sex ratio boys/girls at 2.3, and average age at 7.5±3.2 years (2-13). Mean consultation time was 10.5±8.3 months. Circumstances of discovery: headaches - visual disturbances (76.9%), growth retardation (15.4%) and polyuropolydipsia syndrome (7.7%). Average dimensions (mm±SD): average height 35.1±15.4, transverse diameter 30.1±13.7, antero-post diameter 34.0±15.3, extremes 15-95 mm. Extensions (Percentage): Supra sellar (85.5), Infra sellar (16.2), posterior (21.1), Multidirectional extensions (35.5). Signs of anterior pituitary insufficiency 89.2%, thyrotropic deficiency 59.2%, corticotropic deficiency 44.1 % and growth hormone deficiency 25%, Hyperprolactinémie (PRL ˃25 ng/ml) 23.0%. Complications: hypothalamic syndrome 30.8%, epilepsy 11.5%, diabetes insipidus 23%. Neuropsychiatric complications (55.1%), ophthalmological (79.8%), blindness 23%, hydrocephalus 68.7%.

Discussion: Significant pituitary, hypothalamic and neuro-visual morbidity accompanied craniopharyngiomas. The consequences of a delay in diagnosis increases the frequency and severity of complications, hence the need for early diagnosis in order to control this morbidity, the burden of which is considerable on the health system.