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Case Reports
. 2018 Oct-Dec;14(4):549-555.
doi: 10.4183/aeb.2018.549.

CRANIOPHARYNGIOMA - CLINICAL AND THERAPEUTIC OUTCOME DATA IN A MIXED COHORT OF ADULT AND PAEDIATRIC CASES

C Capatina  1   2 , M Vintila  2 , I Gherlan  1   3 , A Dumitraşcu  2 , A Caragheorgheopol  2 , C Procopiuc  3 , V Ciubotaru  4 , C Poiana  1   2
Affiliations
Case Reports

CRANIOPHARYNGIOMA - CLINICAL AND THERAPEUTIC OUTCOME DATA IN A MIXED COHORT OF ADULT AND PAEDIATRIC CASES

C Capatina et al. Acta Endocrinol (Buchar). 2018 Oct-Dec.

Abstract

Background: Craniopharyngiomas are benign but locally invasive tumours of the sellar region that arise from ectopic embryonic remnants of Rathke's pouch, affecting both children (adamantinomatous type -aCP) and adults (papillary type -pCP) and associated with significant morbidity.

Objective: To study the clinical presentation of CRF as well as the posttreatment evolution of craniopharyngioma in children versus adults in a large mixed cohort.

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

Results: A total of 107 patients (72 adults, 35 children) with a mean follow-up of 6.2 years were included. The presenting symptoms were mostly headache, visual impairment, symptoms of hypopituitarism, diabetes insipidus. Some symptoms or hormonal abnormalities were significantly more prevalent in the children group (p<0.05): nausea/ vomiting (47.8% vs 16.7%), photophobia (21.7% vs 5.6%), diabetes insipidus(28.5% vs 8.3%), GH deficiency (68.8% vs 17.1%). Impaired visual acuity (67.6%of cases) or visual fields (71.4%) were more frequent in adults compared to children (44.1%; 51.6%). The tumor dimensions were similar in both groups (3.05± 1.05 cm in children; 2.7± 1.07 cm in adults). Massive suprasellar extension reaching the third ventricle was frequently present in all cases. All cases underwent surgery but only a minority of those not cured received postoperative adjuvant radiotherapy. Frequent postoperative complications were: aggravation of the endocrine deficit (>80% of cases in both groups needed chronic replacement therapy), central diabetes insipidus (68.2% children, 34.3% of adults).

Conclusions: Despite similar tumor dimensions and extension compared to adults, craniopharyngioma in children is more frequently associated with signs of intracranial pressure. The results and complications of treatment are similar in adults and children.

Keywords: adults; children; craniopharyngioma; outcome; presentation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
The most frequent symptoms at diagnosis CN- cranial nerves, GHD- Growth Hormone Deficiency, DI- Diabetes insipidus, VA - Visual acuity, VF- Visual field.
Figure 2.
Figure 2.
The evolution of the visual function after surgery.
Figure 3.
Figure 3.
The evolution of the tumor remnant after surgery.
Figure 4.
Figure 4.
The type of treatment applied.
Figure 5.
Figure 5.
Weight evolution after treatment.
See this image and copyright information in PMC

References

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