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Endocrine Abstracts (2012) 29 S38.2

ICEECE2012 Symposia Craniopharyngioma: Hypothalamic complications (3 abstracts)

Hypothalamic disorders in Clinical practice; relevance to clinical practice

C J Thompson


Beaumont Hospital, Dublin, Ireland.


Craniopharyngioma (CP) is associated with considerably higher mortality and morbidity than pituitary adenomas. The tumours are rare, but present a considerable management challenge. In addition to the endocrine and mass effects which are common to all tumours arising from the region of the pituitary fossa, the site, size, and sometimes the treatment of CP, dictate that the endocrinologist must also manage hypothalamic complications. Endocrinologists are aware of the high frequency of diabetes insipidus in CP, which, in contrast to pituitary adenomas, may be present prior to surgical intervention. However diabetes insipidus may be complicated in craniopharyngioma by thirst disturbances. These include adipsia/hypodipsia, which predisposes to hypernatraemia, particularly during intercurrent illness, and polydipsia, which may lead to hyponatraemia when the patient is treated with desmopressin for DI. Obesity is very common in CP patients and is most likely multifactorial; some patients have polyphagia and are sometimes referred to as having hypothalamic obesity, whereas others have somnolence and low exercise levels. The contribution of hormonal disturbances to obesity remains to be fully explained. A number of groups have shown disturbances of sleep, including obstructive sleep apnoea, in CP, and daytime somnolence in the absence of sleep disorders has also been reported. The heterogenous nature of somnolence in CP indicates that patients should be fully evaluated as a number of therapeutic interventions are available which can improve quality life. Many authorities have hypothesised that hypothalamic complications of CP may be related to the effects of destructive neurosurgery and recommendations for less extensive surgery with post operative radiotherapy is partly predicated on aspirations to minimise high morbidity hypothalamic complications in CP patients.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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