Endocrine Abstracts

JOINT2102

Introduction: Childhood suprasellar brain tumors (SBT) may cause growth retardation with simultaneous weight gain due to hypothalamic dysfunction. Many parents experience delay in diagnosis, with in hindsight pre-existing slower growth and increase in BMI. Earlier detection of SBT could prevent additional complications, such as visual impairment.

Aim: To assess whether the current referral criteria in growth monitoring by youth health care services can timely detect SBT, and whether additional criteria can lead to earlier detection.

Methods: Data were analyzed from a cohort of children diagnosed with SBT at ages 3-18y (n = 139) and compared to controls (healthy children registered at the youth healthcare service). New referral criteria based on change of height standard deviation score (HSDS) and/or BMI SDS were assessed.

Results: In the SBT cohort, 22.6% (12/53) of children with childhood craniopharyngioma (cCP), 10.8% (7/65) with low-grade glioma (LGG), and 0% (0/21) with germ cell tumor (GCT) met the current referral criteria. Had the current referral criteria been strictly followed, 47.4% (9/19) of the SBT cohort could have been detected 1y earlier than their age of diagnosis. By extending the referral criteria with ΔHSDS<-1, an additional 11 children with SBT (6 cCP, 3 LGG and 2 GCT) would be identified. Of all SBT children meeting this criterion (n = 23), 52.2% (12/23) would have been referred at least one year earlier than their age of diagnosis. This new criterion would lead to referral of 7 months earlier than the current criteria. When extending the guideline with ΔHSDS<-0.75 and ΔBMI SDS>0.5, 5 additional SBT children were identified compared to extension with ΔHSDS<-1.

Conclusion: Extending the current referral criteria for growth monitoring may enable earlier identification of children with SBT. However, even with the current criteria children seem to be diagnosed later than necessary. Raising awareness among parents and healthcare professionals about impaired growth as a potential early warning sign for SBT is crucial to effectively implement these criteria. Also, adding additional criteria, e.g. checking for neurological or visual symptoms in patients with growth faltering, may further lead to earlier diagnosis. The pending results from the control group will provide insight into the specificity of these new referral criteria.