Endocrine sequelae of childhood craniopharyngioma

The endocrine sequelae of 62 children with craniopharyngioma were studied r etrospectively. These patients were followed for a median duration of 3 yea rs (range 1 to 10 years). Eighteen patients had a long-term follow-up for m ore than 5 years (range 5 to 10 years). Complete surgical resection was ach ieved in 30 patients and 32 patients had residual tumor. Twenty-five patien ts had recurrence or progression of the residual tumor and were treated wit h radiotherapy. Presenting complaints suggestive of endocrinopathy were inf requent. The most common presenting symptoms were headache, nausea and vomi ting, followed by growth failure. Pre-operatively, growth hormone deficienc y was the most commonly encountered pituitary hormonal deficiency; however postoperatively, most children had diabetes insipidus. Multiple pituitary h ormonal deficiencies were more frequently observed in children treated with extensive radical surgery than in those treated with conservative surgery and radiotherapy. The endocrine morbidity associated with craniopharyngioma and its different management modalities remains high; however, it is manag eable with appropriate hormonal replacement therapy.