Endocrine Abstracts

Background: The craniopharyngioma is a non-endocrine tumor, developed along the infundibulo-pituitary axis, from the 3^rd ventricle to sphenoid, histologically benign but locally invasive. It is a tumor with serious complications because of its location, its considerable potential for extension, its tendency to recur, and its adhesions to neighbouring structures. Our aim is to assess hormonal, neuro-ophthalmological and metabolic complications at the diagnosis of craniopharyngiomas.

Patients and methods: It is a multicentre Cross-sectional descriptive study in the town of Oran, with prospective and retrospective data collection. MRI, hormonal, biochemical and ocular tests, made the diagnosis. Data entry and analysis were performed with CDC Epi Info version 6 (USA), SPSS 20, Statistica10.

Results: In our study, we collected 86 non-adenomatous tumours, among them 26 craniopharyngiomas (35%), sex ratio men/women at 1.3. Average age at 17.3±13.5 years (2-56). Mean consultation time 20.5±25.3 (1-96) months (range). Circumstances of discovery: headaches - visual disturbances (79.8%), growth retardation (15.4%) and hypogonadism in adults (20.4%). Average dimensions (mm±SD): average height 39.1±17.4, transverse diameter 32.2±14.9, antero-post diameter 36.0±17.5, extremes 15-95 mm. Extensions (percentage): Supra sellar (88.5), Infra sellar (46.2), posterior (23.1), Multidirectional extensions (38.5). Anterior pituitary insufficiency 96.1%, multiple anterior pituitary deficiencies 77.5%, hypothalamic syndrome 30.8%, epilepsy 11.5%, diabetes insipidus 23%. Neuropsychiatric complications (55.1%), ophthalmological (79.8%), blindness 23%, hydrocephalus 68.7%.

Discussion: Craniopharyngiomas are accompanied by significant pituitary, hypothalamic and neuro-visual morbidity. The consequences of a delay in diagnosis increases the frequency and severity of complications, hence the need for early diagnosis in order to control this morbidity, the burden of which is considerable on the health system.