Real life data of obesity in craneopharyngiomas in an pediatric/adult transition pituitary unit

Clara Sola; Felicia Hanzu; Karen Castillo; Toffoli Maria Victoria; Mireia Mora; Paula Casano-Sancho

doi:10.1530/endoabs.110.P781

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Endocrine Abstracts (2025) 110 P781 | DOI: 10.1530/endoabs.110.P781

ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)

Real life data of obesity in craneopharyngiomas in an pediatric/adult transition pituitary unit

Clara Sola ¹ , Felicia Hanzu ¹ , Karen Castillo ² , Maria Victoria Toffoli ² , Mireia Mora ¹ & Paula Casano-Sancho ^{2 3 4}

Author affiliations

¹Hospital Clinic Endocrinology, Barcelona, Spain; ²Hospital Sant Joan de Déu, Pediatric Endocrinologist, barcelona; ³Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029, Madrid, Spain; ⁴Endocrinology Department, Institut de Recerca Sant Joan de Déu, University of Barcelona, 08950 Esplugues, Barcelona, Spain

JOINT3937

Introduction: Craniopharyngiomas (Cr) are suprasellar tumors with metabolic comorbidities and panhypopituitarism diagnosed mostly during infancy with a difficult management. Long-term follow-up in a specialized hypothalamic-pituitart unit (HPU), involving both pediatric and adult endocrinologists, allows for a comprehensive analysis of disease progression and response to treatment, helping to refine therapeutic strategies.

Aims: To evaluate the incidence, comorbidities and progression of hypothalamic obesity (Ob) in pediatric (POCr) and adult-onset Cr (AOCr), the different medical treatments of Ob and the factors that contribute to the development of Ob.

Methods: Retrospective study on patients with Cr and followed up in the HPU between 2008 and 2024.

Results: 35 Cr were included. 24 POCr and 11 AOCr. Among AOCr, 33% had prior diagnosis of POCr. 98% adamantinomatous Cr. Longest follow-up was of 12 years (y) in the POCr and 14y in AOCr. The mean age in POCr was 6.9 ± 3.15y; 60% males; 4% with Ob or BMI SD + 1; 30% visual defects, 70% compression, 8% growth retardation and 25% consciousness alteration. The mean age in AOCr was 53 ± 11.7y; 55% men, more Ob (19%), more visual defects (72%) and hypopituitarism symptoms (28%); 30%HTA, 64% triglyceridemia, 9%DM were observed. After surgery complete panhypo was presented in all; increase in Ob was equal between AOCr and POCr (delta 26 vs 29%), while new DM and hypertrigliceridemia was present only in AOCr (27% and rsp 75%). Highest increase in BMI (SD BMI) was observed at 6 months (m) in AOCr (delta 5 kg/m2) with further stabilization while the highest increase in POCr was at 3m (BMI SD 1.62) and progress during follow-up. Hypothalamus alterations on MRI associated with Ob onset after surgery. Pharmacological treatment was larger and in more POCr than AOCr: 54% vs 45% and 146 vs 35, 6 m; only GLP1 in AOCr; 70%with Lisdexanfetamina (LSDF) in POCr and 30% with GLP1. Interruption of treatment due to AE was higher in LSDF than in GLP1 (50% vs 16%, P < 0.05). Weight loss with GLP1 and LSDF was 2% in AOCr and weight gain was controled in POCr. After short term treatment retrival BMI SD increase with +1.65 in POCr and +2.1 kg/m2 BMI in AOCr.

Conclusion: Although long-term treatment with GLP-1 and LSDF did not result in significant weight loss, it helped stabilize weight gain in both AOCr and POCr. This suggests that this may contribute to better weight control in Cr with hypothalamic dysfunction.