Endocrine Abstracts

JOINT2925

Background: Intracranial tumors affecting the hypothalamic-pituitary (HP) region, including adjacent structures such as the optic pathway, often disrupt the hypothalamic-pituitary axis due to local tissue damage, neurosurgical intervention, tumor progression, or cranial radiation therapy. Tumors located in the suprasellar and intrasellar regions account for approximately 10% of all central nervous system (CNS) tumors in children, with endocrine abnormalities frequently present at diagnosis.

Aim: Of this monocentric study is to evaluate the endocrine profile of children with HP region tumors who have been managed in our hospital and referred to our Endocrine Department, emphasizing pre- treatment and post- treatment complications and outcomes.

Methods: A retrospective analysis was conducted on pediatric HP tumor cases managed between 2013 and 2023. Endocrine data, including pre- and post-treatment deficiencies, BMI changes, and rGH therapy requirements, were extracted from patient records.

Results: • Demographics: Among 41 children (56% girls, 44% boys), the mean age at diagnosis was 8.95 years (SD = 4.8).

• Tumor Diagnosis: Craniopharyngiomas were most common (36.6%), followed by pituitary adenomas (20%) and prolactinomas (12%). Other tumor types included germinoma/dysgerminoma, glioma, ependymoma, astrocytoma, hamartoma, Rathke cyst.

• Pre-treatment Endocrine Status: Hormonal deficiencies included GH (12.8%), TSH (15.38%), ACTH (7.69%), LH/FSH (5.26%), and ADH (12.5%).

• Post-treatment Endocrine Complications: Increased endocrine deficiencies were observed post-treatment, including GH (34.88%), LH/FSH (25.58%), ACTH (51.16%), TSH (67.64%), and ADH (41.86%).

• Body Mass Index (BMI): The mean BMI z-score increased significantly from 1.2 (± 1.54) at diagnosis to 1.7 (± 1.17) at 1-year post-treatment (P < 0.05). This significant difference persisted at 2 years, but by 5 years, although a difference was noted, it almost missed statistical significance at the 95% CI.

• Recombinant Growth Hormone (rGH) Therapy: rGH therapy was initiated in 32% of patients during follow-up.

Conclusion: Early identification and management of endocrine disorders are essential to improve the quality of life and long-term outcomes in pediatric survivors of hypothalamic-pituitary region tumors. Regular monitoring and a multidisciplinary approach are strongly recommended to address the complex health challenges these patients face. However, the results of this study are limited in their generalizability, as the sample was derived specifically from patients referred to the Endocrine Unit. To obtain more comprehensive insights, further studies are needed that include a broader population of patients with all types of brain tumors, regardless of referral pathways or clinical settings.