Endocrine Abstracts

Introduction: Vicinity and adherence of hypothalamic nuclei to craniopharyngioma explain the high rate of complications and difficulties of removal of these tumors.

Subjects and methods: In this retrospective study 50 patients (10 adults and 40 children or adolescents) harboring craniopharyngioma were included. These patients were operated mainly by a frontal approach. We evaluated the frequency of sleep disorders secondary to hypothalamic damage and their predictive factors.

Results: Eight patients (16%) developed hypothalamic syndrome following craniopharyngioma surgery. Sleep disorders in the form of hypersomnia were reported in 3 patients (6%). Other reported abnormalities were: appetite disorders in 8 patients (16%) (one case of anorexia complicated by fatal cachexia and seven cases of polyphagia complicated by morbid obesity, metabolic syndrome and/or steatohepatitis) and thermoregulation disorders in 3 patients (6%). Circulatory and respiratory disorders were not reported in our patients. Extent of surgery and young age were the main predictive factors for the occurrence of hypothalamic damage.

Discussion and conclusion: Sleep disorders were reported in 6% after surgery of craniopharyngioma. Young age and extent of surgery were the main predictive factors. These factors are foreseeable as pediatric craniopharyngioma are of adamantine type. This type of craniopharyngioma is characterized by infiltration of surrounding tissues and a more pronounced peri-tumorous fibrosis making surgical removal more laborious and raising the risk of hypothalamic damage.