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

Patrícia Débora Cavalcanti Tosta-Hernandez; Adriana Aparecida Siviero-Miachon; Nasjla Saba da Silva; Andrea Cappellano; Marcelo de Medeiros Pinheiro; Angela Maria Spinola-Castro

doi:10.1055/a-0641-5956

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2018; 50(09): 675-682
DOI: 10.1055/a-0641-5956

Endocrine Care

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

Autor*innen

Patrícia Débora Cavalcanti Tosta-Hernandez^*

¹Pediatric Endocrinology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil

²Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
Adriana Aparecida Siviero-Miachon^*

¹Pediatric Endocrinology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil

²Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
Nasjla Saba da Silva

²Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
Andrea Cappellano

²Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil
Marcelo de Medeiros Pinheiro

³Rheumatology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil
Angela Maria Spinola-Castro

¹Pediatric Endocrinology Division, Federal University of São Paulo – UNIFESP/EPM, São Paulo, Brazil

²Pediatric Oncology Institute, Federal University of São Paulo – IOP/GRAACC – UNIFESP/EPM, São Paulo, Brazil

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

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Referenzen

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