Endocrine Abstracts

Background: Craniopharyngioma is a rare epithelial tumor of the central nervous system, affecting both children and adults and associated with significant morbidity.

Objective: To study the potential differences in the clinical and radiological presentation of craniopharyngioma in children versus adults in a large mixed cohort.

Material and methods: We performed a retrospective review of craniopharyngioma patients evaluated in the National Institute of Endocrinology in Bucharest between 1990 and 2016.

Results: A total of 82 patients (59 adults, 39.27±15.5 years-old; 23 children, 12.96±4.2 years-old) with a mean follow-up of 6.85 years were included. The presenting symptoms were mostly headache (83% adults, 91.3% children), visual impairment, symptoms of hypopituitarism, diabetes insipidus. Some symptoms or hormonal abnormalities were significantly more prevalent in the children group: nausea, vomiting (47.82% children, 16.94% adults; P=0.006), photophobia (5% adults, 21.73% children; P=0.036), diabetes insipidus (8.4% adults, 30.43% children; P=0.018), GH deficiency (69.56% children; 13.5% adults; P=0.000). Headache, convulsions, cranial nerves paresis, hydrocephalus and ventriculoperitoneal shunt insertion were all more frequent in children, but no statistical significance was reached. Impaired visual acuity (43.13% adults, 13.63% children, P=0.017) or visual fields (69.23% adults, 36.36% children, P=0.006), optic atrophy (47.82% children, 60% adults; P=0.001) were more frequent in adults. The tumor dimensions was similar in both groups. Intratumoral calcifications and cystic components were significantly more prevalent in children (73.91 and 86.95%) than in adults (48.25% and 65.51%); P=0.031 and 0.045, respectively. Massive suprasellar extension reaching the third ventricle was frequently present (27.3% children, 19.23% adults).

Conclusions: Despite similar tumor dimensions and extension compared to adults, craniopharyngioma in children is more frequently associated with signs of intracranial pressure or meningeal irritation. Visual impairment appears to be comparatively less frequent in children with craniopharyngioma.