ESPE Abstracts

Introduction: Craniopharyngiomas can lead to pituitary insufficiency and long-term endocrine complications due to the location, invasive character and risk of recurrence, besides they known as histologically benign.

Aim: In this study, we aimed to evaluate the demographic, clinical features, endocrinological problems and follow-up findings in patient with craniopharyngioma in childhood.

Method: Admission complaints, demographic and clinical features, laboratory and imaging results and follow-up findings of the 27 cases whose were followed up between 2000 and 2020 were evaluated.

Results: Eleven (40%) of the cases were female and 16 (60%) were male. The mean age at diagnosis of the cases was 8.52±3.28 years, the mean follow-up period of the cases was 5.03±4.61 years. Headache was the most frequent complaint, in 13 (48%) of the cases; 8 (30%) had visual symptoms such as double vision, nystagmus, sudden vision loss, and blurred vision, 5 (18%) had short stature, 1 (4%) had increased appetite and rapid weight gain. Average weight SDS at application: -0.01±1.88; height SDS: -1.36±1.64; BMI SDS: 0.59±1.74. At the time of diagnosis, 9 (33%) GH (growth hormone) deficiency, 12 (44%) central hypothyroidism, 2 (7%) adrenal insufficiency due to ACTH deficiency, 5 (19%) gonadotropin deficiency, diabetes insipidus was detected in 3 (11%) of them. There were 16 (%60) patients who were started on growth hormone (GH) treatment and continued to be followed up regularly, and the mean age of onset of GH was 39.38±26.72 months. L-thyroxine treatment was started in 20 of the cases (74%) due to the development of permanent central hypothyroidism. Hydrocortisone treatment was continued after the operation in 18 (66%) of the cases. Sex steroid replacement was performed in 12 (44%) of the cases. Tumor diameter was 38,5±12,92 mm and there was a positive correlation between tumor diameter and obesity frequency in magnetic resonance imagine (r: 0,823; p:0,03). Recurrence was observed in 10 (37%) of 27 patients. Of the 10 cases with recurrence, 7 were operated for the second time, and the other 3 were treated with radiotherapy.

Conclusion: It is known that mortality and morbidity increase as tumor diameter increases in cases with craniopharyngioma. In our study, the correlation between the tumor diameter at the time of diagnosis and the development of obesity highlights the importance of frequent follow-up of children with increased tumor diameter in terms of obesity and other endocrine comorbidities that may develop in the follow-up.