Endocrine Abstracts

Craniopharyngiomas (CF) - a benign tumor of the embryologic origin. The surgical method of treatment is the basic.

Objective: to estimate incidence of hypogonatropic hypogonadism before and after surgical treatment of CF at different topographical variations, and after the preservation of the pituitary stalk.

Methods: The research involved 79 patients older than 18 years (41 women and 38 men) with a mean age - 40 [17; 69] with a verified diagnosis of CF. All patients were operated, in 12 cases the pituitary stalk was saved. Before and 7 days, 3 and 6 months after the surgery all patients were examined by means of hormonal blood tests (LH, FSH, estradiol, testosterone, TSH, free T4, cortisol, prolactin, IGF-1). By localizing tumor patients were divided into 3 groups: 1 – intra-suprasellar (9), 2 – at location of the pituitary stalk (48), 3 –intra-ventricular (22).

Results: hypogonatropic hypogonadism was confirmed. In group 1 : before the surgery - 9 (100%). 3 patients have subtotal ablation. After the surgery the nature of disturbance has not changed. In group 2: hypogonatropic hypogonadism before the surgery - 38 (80%). In 12 cases the pituitary stalk was saved. After the surgery – 46 (96 %). Two women with saved the pituitary stalk had high levels of gonadotropins, respectively postmenopausal period. In group 3: hypogonatropic hypogonadism – 19 (86%, аfter the surgery - 17 (90 %). Reproductive function recovered in two patients (оne woman has a natural pregnancy).

Conclusion: The high incidence of hypogonatropic hypogonadism is caused by the localization of the CF. Preservation of the pituitary stalk does not lead to restoration of the pituitary-gonadal axis in 83 % of cases. Non-radical ablation of ventricular CF can maintain fertility.