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Horm Metab Res 2018; 50(09): 675-682
DOI: 10.1055/a-0641-5956
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Childhood Craniopharyngioma: A 22-Year Challenging Follow-Up in a Single Center

Patrícia Débora Cavalcanti Tosta-Hernandez   *
1   Pediatric Endocrinology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil
2   Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
,
Adriana Aparecida Siviero-Miachon   *
1   Pediatric Endocrinology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil
2   Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
,
Nasjla Saba da Silva
2   Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
,
Andrea Cappellano
2   Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
,
Marcelo de Medeiros Pinheiro
3   Rheumatology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil
,
Angela Maria Spinola-Castro
1   Pediatric Endocrinology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil
2   Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

received 01 May 2018

accepted 05 June 2018

Publication Date:
29 June 2018 (online)

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Abstract

Craniopharyngioma is a sellar/suprasellar benign tumor whose aggressiveness may imply in endocrine disturbances (hypothalamic obesity and hormone deficiencies). Fifty-seven patients were evaluated according to clinical characteristics, hypothalamic involvement, type of treatment, anthropometric variables, adiposity indexes (body mass index Z score category at diagnosis and post-treatment, total body fat, visceral adipose tissue, and metabolic syndrome components) and analyzed through multiple regression and logistic models. Patients were stratified according to growth hormone deficiency and recombinant human growth hormone use. Mean ages at diagnosis and at study evaluation were 9.6 and 16.6 years old, respectively. A set of 43/57 (75.4%) patients presented with important hypothalamic involvement, 24/57 (42.1%) received surgical treatment and cranial radiotherapy, and 8/57 (14%) interferon-α exclusively. Fifty-five patients (96.5%) were considered growth hormone deficient, and 26/57 (45.6%) grew despite no recombinant human growth hormone replacement therapy. At diagnosis, 12/57 (21%) patients were obese, and 33/57 (57.9%) at study evaluation, and after 3.2 years (median) post first therapy. There was no influence of height Z score on body mass index Z score. Body mass index Z score at diagnosis positively influenced body mass index Z score, total body fat, waist circumference and the presence of the metabolic syndrome post-treatment. Replacement of recombinant human growth hormone decreased total body fat and visceral adipose tissue. Craniopharyngioma patients worsened body mass index Z score category 3.2 years (median) after first treatment. Body mass index Z score increased due to real weight gain, without height decrease. Replacement of recombinant human growth hormone had beneficial effect on adiposity.

Key words

obesity - body weight - hypopituitarism - adipose tissue - growth hormone/deficiency

* Both authors contributed equally to this work


 

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