Endocrine Abstracts

Background: Children with brain tumours are known to be at risk of late neuroendocrinopathies due to anatomical and treatment disturbances to central pituitary function.

Aims: To provide a descriptive analysis of a cohort of children with such tumours, referred to the late-effects neuroendocrine service at UCLH. It aims to describe the types of tumour, treatment and current endocrine morbidity of this cohort.

Methods: Cases were identified from the late-effects referral database maintained at UCLH. Cases were excluded due to incorrect tumour site entry in database, death or incomplete/unavailable endocrine status. Analysis was performed using SPSS version 17. Endocrinopathy was defined by currently receiving treatment or demonstrable insufficiency of hormone on last dynamic function test. Endocrine Morbidity Score was calculated to assess outcomes.

Results: Forty patients were identified from the database. After exclusions, 24 patients were analysed. Mean age at diagnosis was 11.01 (S.D. ± 3.87); 16/24 (66%) of tumours were Germinomas. 91.3% of patient received radiotherapy, 55% surgery and 50% chemotherapy. ENDOCRINE STATUS: 21/24 patients were growth hormone deficient (84.5%) at latest follow up, with only 7/24 (29.1%) known to have been tested at tumour diagnosis. EMS score was >2 (GHD+Thyroid/DI+other) in 16/24 (66.6%) patients. Induced puberty was required in 11/24 (45.8%) cases, with precocious puberty occurring in just 1/24 (4.2%).

Conclusions: Neuroendocrine sequalae of non-glioma non-craniopharyngioma type tumours are severe and multiple. Baseline endocrine function of such patients should be investigated prior to treatment to establish origins between tumour and iatrogenic causality, and all patients should be referred to a late neuroendocrine effects service.