ESPE Abstracts

Introduction: Craniopharyngioma is a low malignant potential tumor of embryological origin of the sellar/suprasellar region. It occurs with various symptoms and signs such as headache, vomiting, vision loss and endocrinological disorders. It was aimed to evaluate the presentation findings and endocrinological disorders in the follow-up in childhood craniopharyngioma cases.

Methods: The patients followed up with the diagnosis of craniopharyngioma between 2009 and 2022 in Gazi University Faculty of Medicine Pediatric Endocrinology Department were included in this study. Clinical, laboratory and imaging findings were reviewed retrospectively.

Results: Twenty-two cases (mean age 8.5±3.6 years,72% under 10 years old,68% male) were included in the study. The most common complaints were headache 63%(n=14) and visual impairment 59%(n=13). At the time of admission, at least one pituitary hormone deficiency was detected in 50%(n=11) of the cases. Short stature was accompanied by 41%(n=9) and hypothyroidism was accompanying in 36%(n=8) cases. Although the majority of tumor localization was in the suprasellar region (45%), it was most commonly caused by the infundibulum in 36%(n=8). Compression of the chiasm was observed in 77%(n=17) of the cases. Tumor size was greater than 3 cm in 63%(n=14) of the cases, total excision was applied to 36%(n=8) of the cases. Postoperative radiotherapy was applied in 22%(n=5) and re-operation was applied in 18%(n=4) cases. Multiple pituitary hormone deficiency after surgery was detected in 90%(n=19) of the cases. The incidence of hypothyroidism was 86%(n=19), adrenal insufficiency and diabetes insipidus were observed in 81%(n=18) cases, while transient inappropriate ADH syndrome was observed in 6 cases and central salt loss was observed in 2 cases. In the follow-up, obesity was observed in 41%(n=9) cases and hyperlipidemia was observed in 27%(n=6) cases. While the mean body mass index SDS of the cases was 0.49±1.38 at the time of admission, it was 1.18±1.63 at the last control. 50% of the cases(n=11) received growth hormone treatment.

Conclusion: Because craniopharyngiomas grow slowly and are usually diagnosed late, tumor sizes are quite large at the time of diagnosis. Depending on the size of the tumor/resection before and after surgery, endocrinological problems are frequently observed. Especially in cases with growth arrest, headache and vision problems should be questioned and care should be taken for early diagnosis.