Endocrine Abstracts

JOINT3877

Introduction: Craniopharyngiomas are rare, benign tumors that arise near the pituitary gland, predominantly affecting children and adolescents. Although benign, these tumors can lead to significant morbidity due to their proximity to critical structures like the hypothalamus and pituitary gland. Early diagnosis and appropriate treatment are essential, particularly when hypothalamic involvement occurs, as it can complicate management and influence long-term endocrine function.

Case Description: A 15-year-old female presented with a history of severe, recurrent headaches and syncope. Initial blood and biochemical tests were within normal limits. Endocrine testing revealed normal thyroid function, undetectable LH and subnormal FSH levels, Tanner stage 2 sexual development and decreased height velocity (SDS -1.9 in 2025 vs. SDS -1.3 in 2023). Magnetic resonance imaging (MRI) revealed hydrocephalus and a mass located in the chiasmatic region, suggesting a craniopharyngioma. The patient underwent surgical resection of the mass, and histological examination of the resected tissue confirmed the diagnosis of craniopharyngioma. Postoperatively, the patient developed polyuria, which raised concerns for arginine vasopressin deficiency, thus desmopressin was initiated. Electrolyte disturbances (including sodium and potassium shifts) and low urine specific gravity were observed as well. Given the persistent polyuria (20 L per day), the dose of desmopressin was increased, and within 2-3 days the patient was improved (diuresis 3L per day). Her laboratory results have since normalized. The patient is under ongoing follow-up care by both an endocrinologist and an oncologist for continued monitoring of her recovery and management of potential long-term endocrine effects, including the evaluation of sexual development as part of her follow-up care.

Conclusions: Craniopharyngiomas should be considered in the differential diagnosis of adolescents with unexplained neurological symptoms and growth delay. While the patient’s craniopharyngioma was managed with initial success, the case underscores the necessity of lifelong multidisciplinary follow-up to address hormonal deficiencies, metabolic complications, and psychosocial challenges. It is important to find the balance between tumor control and preserving quality of life in adolescents with this condition.