Endocrine Abstracts

Craniopharyngiomas are rare and histologically benign tumors that are associated with an unfavourable prognosis and controversial optimal treatment. The aim of this retrospective study was to review clinical presentation, natural history and therapeutic outcomes of patients with craniopharyngiomas treated in a single center between 1995 and 2017. In that period, 38 patients (16 children and 22 adults) were diagnosed with craniopharyngioma. Median age at the time of diagnosis in children and adults was 12.5 years (range 6–17) and 40 years (range 19–66), respectively. The most frequent presenting feature was visual field defect in adult patients and headache with intracranial hypertension in children (75% and 69%, respectively). In 16 adults and in 10 children hypothalamic invasion was present on initial MRI, whereas optic chiasm impingement was found in 20 adults and 11 children. Fifteen patients underwent gross total resection of the tumor, 13 patients had partial resection of the tumor combined with radiotherapy (RT), 4 patients had two partial resections together with RT, while 6 patients had partial resection of the tumor and are awaiting further treatment. During a follow-up period of 56.5 months (range 3–264) 10 out of 15 patients had tumor relapse after gross total resection, while 7 out of 17 patients had progression of residual tumor after the partial resection(s) combined with RT. There was no difference in recurrence/progression rate with regard to therapeutic approach (gross total resection vs. partial resection with RT). Median time to recurrence/progression was 36 months (range 8–156). There was no difference in time to recurrence/progression between patients who underwent gross total resection and those with residual tumor. Hypopituitarism and diabetes insipidus (DI) were found significantly more often after the treatment in all patients (P<0.001), while body mass index (BMI) significantly increased one year after the treatment (22.4 kg/m² (15.3–26.1) vs 28.1 kg/m²; P<0.001). There were no statistically significant differences in the incidence of hypopituitarism, DI and obesity regarding therapeutic approach. Our results showed no differences in progression-free survival and the incidence of hypopituitarism, DI and obesity between gross total resection and partial resection with RT.