Abstract
Objective
Children treated for craniopharyngioma (CP) experience significant morbidity. We aimed to investigate the clinical characteristics and postoperative complications of pediatric CP and to determine risk factors for complications to provide a theoretical basis for postoperative treatment.
Methods
In this retrospective analysis, we screened clinical data concerning children with CP who had undergone surgery at our hospital from December 2011 to June 2015. We statistically analyzed the relationship between age, sex, disease course, tumor location, extent of tumor resection, and neuroendocrine axis dysfunction.
Results
Of 240 patients (males, n = 144; females, n = 96; mean age, 8.33 ± 4.64 years), the main clinical presentations were headache (n = 151, 62.92%), vomiting (n = 84, 35%), vision changes (n = 101, 42.08%), polydipsia and polyuria (n = 47, 19.58%), and growth retardation (n = 42, 17.5%). Hypothalamic-pituitary dysfunction was the most common postoperative complication. There were 216 (90.00%) and 181 (75.42%) patients with pituitary-thyroid and pituitary-adrenal axis injuries, respectively. Being a prepubescent girl was a risk factor for impaired pituitary-thyroid and pituitary-adrenal axis function (P < 0.05). No correlation was found between sex (male), age, disease course, tumor location, extent of tumor resection, and impaired pituitary-thyroid and pituitary-adrenal axis function (P > 0.05). Pituitary-gonad axis injury was observed in 91 (37.92%) patients. Saddle and suprasellar region tumors were risk factors for impaired pituitary-gonad axis function (P < 0.05). No statistically significant correlation was found between sex, disease course, extent of resection, and impaired pituitary-gonad axis function (P > 0.05).
Conclusions
Routine screening for complications during treatment is indicated for children with CP, to optimize the timing of interventions and reduce long-term morbidity.
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References
Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551
Nielsen EH, Feldt-Rasmussen U, Poulsgaard L, Kristensen LO, Astrup J, Jorgensen JO et al (2011) Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults. J Neurooncol 104:755–763
Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C et al (2017) Cbtrus statistical report: primary brain and other central nervous system tumors diagnosed in the united states in 2010–2014. Neuro Oncol 19:v1–v88
Jensterle M, Jazbinsek S, Bosnjak R, Popovic M, Zaletel LZ, Vesnaver TV et al (2019) Advances in the management of craniopharyngioma in children and adults. Radiol Oncol 53:388–396
Bogusz A, Muller HL (2018) Childhood-onset craniopharyngioma: latest insights into pathology, diagnostics, treatment, and follow-up. Expert Rev Neurother 18:793–806
Rickert CH, Paulus W (2001) Epidemiology of central nervous system tumors in childhood and adolescence based on the new who classification. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 17:503–511
Cheng J, Fan Y, Cen B (2017) Effect of preserving the pituitary stalk during resection of craniopharyngioma in children on the diabetes insipidus and relapse rates and long-term outcomes. J Craniofac Surg 28:e591–e595
Cheng J, Shao Q, Pan Z, You J (2016) Analysis and long-term follow-up of the surgical treatment of children with craniopharyngioma. J Craniofac Surg 27:e763–e766
Muller HL (2010) Childhood craniopharyngioma–current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol 6:609–618
Hoffmann A, Boekhoff S, Gebhardt U, Sterkenburg AS, Daubenbuchel AM, Eveslage M et al (2015) History before diagnosis in childhood craniopharyngioma: associations with initial presentation and long-term prognosis. Eur J Endocrinol 173:853–862
Mortini P, Losa M, Pozzobon G, Barzaghi R, Riva M, Acerno S et al (2011) Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. J Neurosurg 114:1350–1359
Wijnen M, van den Heuvel-Eibrink MM, Janssen J, Catsman-Berrevoets CE, Michiels EMC, van Veelen-Vincent MC et al (2017) Very long-term sequelae of craniopharyngioma. Eur J Endocrinol 176:755–767
Tan TSE, Patel L, Gopal-Kothandapani JS, Ehtisham S, Ikazoboh EC, Hayward R et al (2017) The neuroendocrine sequelae of paediatric craniopharyngioma: a 40-year meta-data analysis of 185 cases from three uk centres. Eur J Endocrinol 176:359–369
Puget S, Garnett M, Wray A, Grill J, Habrand JL, Bodaert N et al (2007) Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 106:3–12
Boekhoff S, Bogusz A, Sterkenburg AS, Eveslage M, Muller HL (2018) Long-term effects of growth hormone replacement therapy in childhood-onset craniopharyngioma: results of the german craniopharyngioma registry (hit-endo). Eur J Endocrinol 179:331–341
Muller HL (2017) Diagnosis, treatment, clinical course, and prognosis of childhood-onset craniopharyngioma patients. Minerva Endocrinol 42:356–375
Sun F, Sun X, Du X, Xing H, Yang B (2017) Factors related to endocrine changes and hormone substitution treatment during pre- and post-operation stages in craniopharyngioma. Oncol Lett 13:250–252
Kendall-Taylor P, Jonsson PJ, Abs R, Erfurth EM, Koltowska-Haggstrom M, Price DA et al (2005) The clinical, metabolic and endocrine features and the quality of life in adults with childhood-onset craniopharyngioma compared with adult-onset craniopharyngioma. Eur J Endocrinol 152:557–567
Muller HL, Merchant TE, Puget S, Martinez-Barbera JP (2017) New outlook on the diagnosis, treatment and follow-up of childhood-onset craniopharyngioma. Nat Rev Endocrinol 13:299–312
Chen JX, Alkire BC, Lam AC, Curry WT, Holbrook EH (2016) Aseptic meningitis with craniopharyngioma resection: consideration after endoscopic surgery. J Neurol Surg Rep 77:e151–e155
Steno J (1985) Microsurgical topography of craniopharyngiomas. Acta Neurochir Suppl 35:94–100
Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P (1990) Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg 73:3–11
Pascual JM, Gonzalez-Llanos F, Barrios L, Roda JM (2004) Intraventricular craniopharyngiomas: topographical classification and surgical approach selection based on an extensive overview. Acta Neurochir 146:785–802
Bakhsheshian J, Jin DL, Chang KE, Strickland BA, Donoho DA, Cen S et al (2016) Risk factors associated with the surgical management of craniopharyngiomas in pediatric patients: analysis of 1961 patients from a national registry database. Neurosurg Focus 41:E8
de Vile CJ, Grant DB, Hayward RD, Kendall BE, Neville BG, Stanhope R (1996) Obesity in childhood craniopharyngioma: relation to post-operative hypothalamic damage shown by magnetic resonance imaging. J Clin Endocrinol Metab 81:2734–2737
Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI (1992) Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76:47–52
Sterkenburg AS, Hoffmann A, Gebhardt U, Warmuth-Metz M, Daubenbuchel AM, Muller HL (2015) Survival, hypothalamic obesity, and neuropsychological/psychosocial status after childhood-onset craniopharyngioma: newly reported long-term outcomes. Neuro Oncol 17:1029–1038
Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E (2004) Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol 46:220–229
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Yaxian, D., Chunmei, Y., Juanyu, X. et al. An analysis of clinical characteristics and postoperative complications in children craniopharyngioma. Childs Nerv Syst 37, 3033–3040 (2021). https://doi.org/10.1007/s00381-021-05277-7
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DOI: https://doi.org/10.1007/s00381-021-05277-7