Endocrine Abstracts

Objective: Studies comparing endocrine and metabolic outcomes of childhood- and adult-onset craniopharyngioma (CP) are generally based on the age-of-disease onset only. The aim of this study was to analyze the role of histological tumor subtype (adamantinomatous (aCP) or papillary (pCP)) on the development of long-term endocrine and metabolic CP comorbidities.

Methods: 47 patients with CP treated from 1979 onwards (19 patients with childhood-onset disease) in a single center university institution were included. Median follow-up since presentation was 13 years (interquartile range: 0.2 – 38 years) and comparable between age-of-disease-onset and histological subtype groups. Data on tumor histology was extracted from patients’ records, and re-evaluated by a single by an experienced pathologist when tissue samples were still available.

Results: At presentation 54% of childhood- and 41% of adult-onset CP patients had at least one pituitary axis affected. Individual hormonal axis were similarly affected when groups were compared by age-of-diagnosis or histology subtype. At follow-up 100% of childhood- and 93% of adult-onset patients had at least one pituitary hormone deficiency. Growth hormone (GH) deficiency, central diabetes insipidus and panhipopituitarism were more prevalent in childhood-onset aCP and least prevalent in adult-onset pCP. 20% of childhood-onset CP patients were already obese at diagnosis, whereas none of the adult-onset patients were obese. At follow-up only 11% of patients with childhood- and 4% of adult-onset CP were normal weight, with obesity rate increasing to 55% in the first and 46% in the latter group. Risk for obesity positively correlated with the presence of hydrocephalus at diagnosis, hypothalamic and third ventricular floor damage after surgery. Metabolic syndrome (MetS) was present in 80% of childhood- and 68% of adult-onset patients.

Conclusions: Long-term endocrine and metabolic complications are very frequent in CP patients. Patients with a CP, especially with childhood-onset, are generally more affected.

Figure 1 Frequency of CP diagnosis according to age-of-diagnosis and histological subtype.

Light blue – pCP

Dark blue – aCP

Data on histological type was missing in 6 childhood-onset CP and 7 adult-onset CP.