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 posttreatment evolution of craniopharyngioma in children and 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. All underwent surgery (57 cases, 69.5% transcranial, 25 cases, 30.48% transsphenoidal approach,), 34 being operated on more than once. 13 patients (15.85%) were irradiated (1 before surgery, the others after). The surgical excision was complete in 26 cases (31.7%). Surgery led to anosmia (in 7 cases), CSF leak (3 cases), subdural hematoma (2 cases). After surgery 21 cases (25.6%) had cognitive impairment, 5 (6.09%) had hypothalamic syndrome (diurnal sleepiness, appetite and memory dysfunction). The endocrine dysfunction was aggravated after treatment in 64 cases (78%), improved in 5 (6%) and stable in 14 cases (17%). The evolution of the tumor revealed stable remnant in 29 cases (35.3%), progressively increasing remnant in 23 (28%), recurrence in 2 (3.4%) and cure in 28 cases (34.14%) during follow-up. There was no significant difference in the complications rate between children and adults.

Conclusions: Craniopharyngioma is a tumor frequently necessitating repeated treatments, associated with very significant morbidity. The results and complications of treatment are similar in adults and children.