Exp Clin Endocrinol Diabetes 2007; 115 - P02_092
DOI: 10.1055/s-2007-972499

Assessment of pituitary function in patients with craniopharyngioma (German CranioNet)

K Reschke 1, I Rieback 1, R Lobmann 1 H Lehnert 2, CranioNet (German Craniopharyngioma Network)
  • 1Otto-von-Guericke University Magdeburg, Department of Endocrinology and Metabolism, Magdeburg, Germany
  • 2Coventry University Hospital, Warwick Medical School, Warwick, United Kingdom

Objectives: Craniopharyngioma are rare, benign tumors associated with failure of hypothalamo-pituitary function and a reduced quality of life. CranioNet is a prospective study for documentation of mostly adult patients with craniopharyngioma in Germany. Within this program, standard diagnostic and therapeutic procedures of the centers involved are assessed.

Methods: Up to now we collected pre- and postoperative data of 62 patients (53 adults: 29 m, 24 f, and 9 children: 5 m, 4 f). In prospective analysis, metabolic sequelae, morbidity and mortality data will also be assessed.

Results: The mean age at diagnosis for adults was 46.0 years (m 47.4, f 44.2 y). Here we present results on corticotropic and growth hormone axis of adult patients. Basal measurement or hormone axis testings and medical therapy are documented preoperatively and 3–19 month after surgery (mostly 6 month). Postoperative data of 41 patients were complete after first surgery, in 12 cases data are missing.

Provocative testing was performed preoperatively in only 25/53 patients. Preoperative corticotropic axis was investigated in 25 (14 ACTH, 9 Insulin hypoglycemia [IHT], 2 CRH tests), growth hormone axis in 13 patients (9 IHT, 3 GHRH, 1 Arginine tests). Postoperatively, corticotropic axis was tested in 12 (4 IHT, 8 ACTH), growth hormone axis in 8 patients (4 IHT, 2 GHRH, 2 GHRH/Arginine), only basal hormone evaluation was done in 24 (ACTH, cortisol) and 16 patients (IGF-1). 29 were on cortisol and 2 on growth hormone replacement.

Neither assessed nor treated with regard to corticotropic axis were 6, to growth hormone axis 18 patients.

Conclusion: Panhypopituitarism is a common finding in patients with craniopharyngioma. With adequate hormone supplementation quality of life and eventually morbidity and mortality can be improved. As our results have shown, medical care of adult craniopharyngioma patients in Germany in respect of testing of pituitary function pre- and postoperatively and hormone replacement has to be improved to attain these goals.