Endocrine Abstracts

Introduction: Craniopharyngioma is a rare benign epithelial tumour arising from the pituitary stalk or pituitary gland, developing in the sellar and suprasellar region, it affects both adults and children, The clinical presentation may include endocrine symptoms suggestive of hypopituitarism, ophthalmologic symptoms, signs of intracranial hypertension and focal neurological signs. However, after surgical treatment, hypothalamic-pituitary endocrine damage is common. The aim of our work was to study the pituitary hormone profile of operated craniopharyngiomas.

Material and Methods: Retrospective descriptive study including 7 patients followed at the Endocrinology-Diabetology-Nutrition Department at the Mohammed VI University Hospital of Oujda Morocco, with surgically treated craniopharyngioma, hospitalised in our department for postoperative hormone exploration.

Results: Four women and three men, aged 21.8±12.6 years, referred for endocrine management of a craniopharyngioma, all patients had visual impact, and the craniopharyngioma was intra and suprasellar in all patients, transphenoidal endoscopy was used for 4 patients, frontal approach was used for 3 of our patients. With regard to the postoperative hormonal profile, 6 patients developed a polyuro-polydipsic syndrome (85.7% of cases), 5 patients had a corticotropic deficiency (71.4% of cases), 2 of whom had this deficiency pre-operatively, the thyreotropic deficiency was observed in 3 patients (42,8% of cases), 1 of these patients had this deficiency pre-operatively, gonadotropic deficiency was observed in 6 patients (85.7% of cases), 2 of whom had hypogonadotropic hypogonadism pre-operatively, and finally somatotropic deficiency was present pre-operatively in only 1 patient. For hormone replacement, it involved hydrocortisone supplementation for corticotropic deficiency, levothyroxine for thyroid insufficiency, estrogen and progestin treatment for women with gonadotropic deficiency, and testosterone replacement therapy for men.

Conclusions: Our study confirms that in craniopharyngiomas, antehypophyseal insufficiency and diabetes insipidus are frequent after surgical treatment. Adequate hormone replacement therapy and long-term medical monitoring are therefore necessary.