Endocrine Abstracts

JOINT3853

Introduction: Craniopharyngioma (CP) is a rare intracranial embryonal malformations of the sellar region. Treatment complications, besides hormonal deficits, include disturbances in the patient’s emotional and cognitive functioning. Previous studies of cognitive functions indicate overall typical intellectual performance with reduced scores in several areas. In contrast, there is still no consensus about the specific patterns of cognitive functioning, which also depend on the tumor’s particular traits and the treatment used.

Aim: Analyze children’s cognitive functioning level after CP treatment and assess the relationship between the course of the disease and treatment and the occurrence of cognitive deficits.

Material and Methods: A study enrolled 40 patients aged 6-18 (the average age at the time of examination was 12.9 years, 25 boys and 15 girls) treated for CP in IP CZD. The Stanford-Binet Intelligence Scales: 5th Edition (SB5), Rey’s Complex Figure Test, and Benton’s Visual Retention Test were used.

Results: The mean age at diagnosis was 9.3 years +/- 3,8 (min. 1.9 max. 16.0). All patients were diagnosed with adamantinomatous CP, and most of the tumor was solid-cystic type. (75%). Calcifications were confirmed in 87,5% of patients. Median tumor size was 41 mm (IQR: 31-52). According to the classification that assesses the position of the tumor in the hypothalamus (Puget’s grading system), most tumors were grade 2 - 63.2% (grade 1 - 26,3%, grade 0 - 10,5%). 12 (30%) children underwent reoperation, 8 (20 %) required ventriculoperitoneal shunt implantation due to hydrocephalus, and 22 (55%) required radiotherapy. The study group scored lower than the normative group in general intellectual potential and memory. Several factors were observed that seem to be associated with better performance in some cognitive tests: cystic tumor, no calcifications, tumor diameter less than 4 cm, 0 and 1 grade of the Puget’s grading system, endonasal surgery, no radiation therapy. Valve implantation seems to be a variable of particular importance - the children who required a ventriculo-peritoneal shunt received lower scores in almost all tests performed.

Conclusions: Children’s general level of cognitive functioning after CP treatment is lower than that of the general population but remains within normal limits. However, a significant reduction in memory function is observed. Factors related to the morphology and location of the tumor, as well as the treatment administered, may reduce the risk of cognitive deficits. Understanding the long-term cognitive sequelae of CP and its treatment requires a broad, interdisciplinary perspective.