Skip to main content

Advertisement

SpringerLink
Log in

Practical approach to childhood craniopharyngioma: a role of an endocrinologist and a general paediatrician

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Objectives

The objectives of this study are to evaluate co-morbidities in patients with craniopharyngioma and to elaborate an interdisciplinary protocol of the follow-up.

Patients and methods

The group comprised 15 children (median age at the diagnosis, 10.1; mean follow-up period, 4 years). All patients had surgical resection of the tumour: gross total in seven, subtotal or partial removal in eight cases. Surgery was followed by radiotherapy in ten cases for tumour residue or progression. Sexual development and auxology were evaluated at diagnosis and during follow-up. Hormones were determined by chemiluminescent immunometric assays. Antidiuretic hormone dysfunction was diagnosed on the grounds of clinical symptoms, water-electrolyte balance, urine specific gravity, and serum osmolality. Metabolic control was monitored by levels of glucose, insulin, lipids, and transaminases; insulin resistance was expressed by homeostatic model assessment (HOMA) index.

Results

At diagnosis, median height standard deviation score (hSDS) was −1.6 (five children being short-statured). Median change hSDS for the whole follow-up was 1.2 (four children decelerating growth). Diabetes insipidus was diagnosed in eight (within 0–1.8 years of the follow-up), hypocorticolism in eight, and hypothyroidism in 12 subjects (within 0–3.75 years for both endocrinopathies). Four patients required sex hormone replacement therapy. At diagnosis, five children were overweight; during follow-up, only four children sustained normal body mass index. Hypertransaminasaemia was found in three, dyslipidaemia in 11, and hyperinsulinaemia in seven patients (with elevated HOMA in four cases).

Conclusions

On the grounds of these observations, the management of craniopharyngioma in our institution includes repeated hormonal and metabolic assays in chosen time intervals. Early detection of co-morbidities and their management involves interdisciplinary team.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Haupt R, Magnani C, Pavanello M, Caruso S, Dama E, Garre ML (2006) Epidemiological aspects of craniopharyngioma. J Pediatr Endocrinol Metab 19(Suppl 1):289–293

    PubMed  Google Scholar 

  2. Karavitaki N, Cudlip S, Adams CBT, Wass JA (2006) Craniopharyngiomas. Endocr Rev 27:371–397

    Article  PubMed  Google Scholar 

  3. DeVile CJ, Grant DB, Hayward RD, Stanhope R (1996) Growth and endocrine sequelae of craniopharyngioma. Arch Dis Child 75:108–114

    Article  PubMed  CAS  Google Scholar 

  4. Halac I, Zimmerman D (2005) Endocrine manifestation of craniopharyngioma. Childs Nerv Syst 21:640–648

    Article  PubMed  Google Scholar 

  5. Palczewska J, Niedzwiecka Z (2001) Wskazniki rozwoju somatycznego dzieci i młodzieży warszawskiej. Med Wieku Rozw 2(Suppl 1):55–56, 113–114

    Google Scholar 

  6. Argente J (1999) Diagnosis of late puberty. Horm Res 51(Suppl 3):95–100

    Article  PubMed  CAS  Google Scholar 

  7. Delemarre EM, Felius B, van de Waal D (2008) Inducing puberty. Eur J Endocrinol 159(Suppl 1):S9–S15

    Article  PubMed  CAS  Google Scholar 

  8. Cizmecioglu FM, Hatun S, Kalaca S (2008) Metabolic syndrome in obese Turkish children and adolescents: comparison of two diagnostic models. Turk J Pediatr 50:359–365

    PubMed  Google Scholar 

  9. Gungor N, Saad R, Janosky J, Arslanian S (2004) Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatr 144:47–55

    Article  PubMed  CAS  Google Scholar 

  10. National Cholesterol Education Program (NCEP) (1992) Highlights of the report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 89:495–501

    Google Scholar 

  11. Gleeson HK, Shalet SM (2004) The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours. Endocr Relat Cancer 11:589–602

    Article  PubMed  CAS  Google Scholar 

  12. Lyen KR, Grant DB (1982) Endocrine function, morbidity and mortality after surgery for craniopharyngioma. Arch Dis Child 57:837–841

    Article  PubMed  CAS  Google Scholar 

  13. Muller HL, Bruhnken G, Emser A, Faldum A, Etavard-Gorris N, Gebhardt U, Kolb R, Sorensen N (2005) Longitudinal study on quality of life in 102 survivors of childhood craniopharyngioma. Childs Nerv Syst 21:975–980

    Article  PubMed  Google Scholar 

  14. Perre-Kahn A, Recassens C, Pinto G, Thalassinos C, Chokron S, Soubervielle JC, Brauner R, Zerah M, Siante Rose C (2005) Social and psycho-intellectual outcome following radical removal of craniopharyngiomas in childhood. Childs Nerv Syst 21:817–824

    Article  Google Scholar 

  15. Muller H (2008) Childhood craniopharyngioma. Horm Res 69:193–202

    Article  PubMed  Google Scholar 

  16. Scott RM (2005) Craniopharyngioma: a personal (Boston) experience. Childs Nerv Syst 21:773–777

    Article  PubMed  Google Scholar 

  17. Hayward R (1999) The present and future management of childhood craniopharyngioma. Childs Nerv Syst 15:764–769

    Article  PubMed  CAS  Google Scholar 

  18. Albright AL, Hadjipanayis CG, Lunsford LD, Kondziolka D, Pollack IF, Adelson PD (2005) Individualized treatment of pediatric craniopharyngiomas. Childs Nerv Syst 21:649–654

    Article  PubMed  Google Scholar 

  19. Caldarelli M, Massimi L, Tamburrini G, Cappa M, Di Rocco C (2005) Long-term results of the surgical treatment of craniopharyngioma: the experience at the Policlinico Gemelli, Catholic University, Rome. Childs Nerv Syst 21:747–757

    Article  PubMed  CAS  Google Scholar 

  20. Karavitaki N, Brufani C, Warner JT, Adams CBT, Richards P, Ansorge O, Shine B, Turner HE, Wass JAH (2005) Craniopharyngioma in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol (Oxf) 62:397–409

    Article  CAS  Google Scholar 

  21. Tiulpakov AN, Mazerkina NA, Brook CGD, Hindmarsh PC, Peterkova VA, Gorelyshev SK (1998) Growth in children with craniopharyngioma following surgery. Clin Endocrinol (Oxf) 49:733–738

    Article  CAS  Google Scholar 

  22. Pinto G, Bussieres L, Recasens C, Souberbielle JC, Zerah M, Brauner R (2000) Hormonal factors influencing weight and growth pattern in craniopharyngioma. Horm Res 53:163–169

    Article  PubMed  CAS  Google Scholar 

  23. Geffner M, Lundberg M, Koltowska-Haggstrom M, Abs R, Verhelst J, Erfurth EM, Kendall-Taylor P, Price DA, Jonsson P, Bakker B (2004) Changes in height, weight and body mass index in children with craniopharyngioma after three years of growth hormone therapy: analysis of KIGS (Pfizer International Growth Database). J Clin Endocrinol Metab 89:5435–5440

    Article  PubMed  CAS  Google Scholar 

  24. Schoenle EJ, Zapf J, Prader A, Torresani T, Werder EA, Zachmann M (1995) Replacement of growth hormone (GH) in normally growing GH-deficient patients operated for craniopharyngioma. J Clin Endocrinol 80:374–378

    Article  CAS  Google Scholar 

  25. Karavitaki N, Warner JT, Marland A, Shine B, Ryan F, Arnold J, Turner HE, Wass JA (2006) GH replacement does not increase the risk of recurrence in patients with craniopharyngioma. Clin Endocrinol (Oxf) 64:556–560

    Article  CAS  Google Scholar 

  26. Lustig RH, Post SR, Srivannaboon K, Rose SR, Danish RK, Burghen GA, Xiong X, Wu S, Merchant TE (2003) Risk factors for development of obesity in children surviving brain tumors. J Clin Endocrinol Metab 88:611–616

    Article  PubMed  CAS  Google Scholar 

  27. Muller HL, Emser A, Faldum A, Bruhnken G, Etavard-Goris N, Gebhardt U, Oeverink R, Kolb R, Sorensen N (2004) Longitudinal study on growth and body mass index before and after diagnosis of childhood craniopharyngioma. J Clin Endocrinol Metab 89:3298–3305

    Article  PubMed  Google Scholar 

  28. DeVile CJ, Grant DB, Hayward RD, Kendall BE, Neville BGR, Stanhope R (1996) Obesity in childhood craniopharyngiomas: relation to post-operative hypothalamic damage shown by magnetic resonance imaging. J Clin Endocrinol Metab 81:2734–2737

    Article  CAS  Google Scholar 

  29. Hukin J, Visser J, Sargent M, Goddard K, Fryer C, Steinbok P (2005) Childhood craniopharyngioma: Vancouver experience. Childs Nerv Syst 21:758–765

    Article  PubMed  Google Scholar 

  30. Lustig RH, Rose SR, Burghen GA, Velasquez-Mieyer P, Broome DC, Smith K, Li H, Hudson MM, Heideman RL, Kun LE (1999) Hypothalamic obesity in children caused by cranial insult: altered glucose and insulin dynamics, and reversal by a somatostatin agonist. J Pediatr 135:162–168

    Article  PubMed  CAS  Google Scholar 

  31. Harz KJ, Muller HL, Waldeck E, Pudel V, Roth C (2003) Obesity in patients with craniopharyngioma: assessment of food intake and movement counts indicating physical activity. J Clin Endocrinol Metab 88:5227–5231

    Article  PubMed  CAS  Google Scholar 

  32. Siviero-Miachon AA, Spinola-Castro AM, Guerra-Junior G (2008) Detection of metabolic syndrome features among childhood cancer survivors: a target to prevent disease. Vasc Health Risk Manag 4:825–836

    PubMed  Google Scholar 

  33. Bramnert M, Segerlanz M, Laurila E, Daugaard JR, Manhem P, Groop L (2003) Growth hormone replacement therapy induces resistance by activating the glucose-fatty acid cycle. J Clin Endocrinol Metab 88:1455–1463

    Article  PubMed  CAS  Google Scholar 

  34. Srinivasan S, Ogle GD, Garnett SP, Briody JN, Lee JW, Cowell CT (2004) Features of metabolic syndrome after childhood craniopharyngioma. J Clin Endocrinol Metab 89:81–86

    Article  PubMed  CAS  Google Scholar 

  35. Bloomgarden ZT (2003) American Association of Clinical Endocrinologists (AACE) consensus conference on the insulin resistance syndrome: 25–26 August 2002, Washington, DC. Diabetes Care 26(933–939):1297–1303

    Article  PubMed  Google Scholar 

  36. Yeckel CW, Weiss R, Dziura J, Taksali SE, Dufour S, Burgert TS, Tamborlane WV, Caprio S (2004) Validation of insulin sensitivity indices from oral glucose tolerance test parameters in obese children and adolescents. J Clin Endocrinol Metab 89:1096–1101

    Article  PubMed  CAS  Google Scholar 

  37. Manco M, Bottazo G, DeVito R, Marcellini M, Mingrone G, Nobili V (2008) Nonalcoholic fatty liver disease in children. J Am Coll Nutr 27:667–676

    PubMed  CAS  Google Scholar 

  38. Mason PW, Krawiecki N, Meacham LR (2002) The use of dextroamphetamine to treat obesity and hyperphagia in children treated for craniopharyngioma. Arch Pediatr Adolesc Med 156:887–892

    PubMed  Google Scholar 

  39. Muller HL, Gebhardt U, Wessel V, Schroder S, Kolb R, Sorensen N, Maroske J, Hanisch E (2007) First experiences with laparoscopic adjustable gastric banding (LAGB) in the treatment of patients with childhood craniopharyngioma and morbid obesity. Klin Padiatr 219:323–325

    Article  PubMed  CAS  Google Scholar 

  40. Sosa IJ, Krieger MD, McComb JG (2005) Craniopharyngioma of childhood: the CHLA experience. Childs Nerv Syst 21:785–789

    Article  PubMed  Google Scholar 

  41. Smith D, Finucane F, Phillips J, Baylis PH, Finucane J, Tormey W, Thompson CJ (2004) Abnormal regulation of thirst and vasopressin secretion following surgery foir craniopharyngioma. Clin Endocrinol (Oxf) 61:273–279

    Article  CAS  Google Scholar 

  42. Cuisset JM, Cuvellier JC, Vallee L, Ryckewaert P, Soto-Ares G, Nuyts JP (1999) Holoprosencephaly with neurogenic hypernatremia. Arch Pediatr 6:43–45

    Article  PubMed  CAS  Google Scholar 

  43. Ghirardello S, Hopper N, Albanese A, Maghnie M (2006) Diabetes insipidus in craniopharyngioma: postoperative management of water and electrolyte disorders. J Pediatr Endocrinol Metab 19(Suppl. 1):413–421

    PubMed  Google Scholar 

  44. Tomlinson JW, Holden N, Hills RK, Wheatley K, Clayton RN, Bates AS, Sheppard MC, Stewart PM, West Midlands Prospective Hypopituitary Study Group (2001) Association between premature mortality and hypopituitarism. Lancet 357:3897–3904

    Article  Google Scholar 

Download references

The authors declare that there are no proprietary, financial, professional, or other personal interests that may inappropriately influence positions presented in the manuscript.

Author information

Authors and Affiliations

  1. Department of Paediatric Endocrinology and Diabetes, Medical University of Silesia, Medykow 16, 40-752, Katowice, Poland

    Maria A. Kalina, Barbara Kalina-Faska & Ewa Malecka-Tendera

  2. Department of Paediatric Endocrinology and Diabetes, Upper Silesia Centre for Child’s Health, Medykow 16, 40-752, Katowice, Poland

    Eliza Skala-Zamorowska

  3. Division of Paediatric Neurosurgery, Upper Silesia Centre for Child’s Health, Medykow 16, 40-752, Katowice, Poland

    Marek Mandera

Authors
  1. Maria A. Kalina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eliza Skala-Zamorowska
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara Kalina-Faska
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ewa Malecka-Tendera
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marek Mandera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria A. Kalina.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kalina, M.A., Skala-Zamorowska, E., Kalina-Faska, B. et al. Practical approach to childhood craniopharyngioma: a role of an endocrinologist and a general paediatrician. Childs Nerv Syst 25, 1053–1060 (2009). https://doi.org/10.1007/s00381-009-0931-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-009-0931-6

Keywords

Search

Navigation