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Disease and Treatment-Related Hypothalamic Alterations in Craniopharyngioma: Clinical Presentation, Prognostic Impact, and Implications for Treatment Strategies

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Adult Craniopharyngiomas

Abstract

Hypothalamic obesity frequently occurs in craniopharyngiomas (CP) patients due to disease or treatment-related damage to medial hypothalamic structures, encompassing arcuate nucleus, paraventricular nucleus, ventromedial nucleus, dorsomedial nucleus, and dorsal hypothalamic area, which are critically involved in the regulation of satiety and energy balance through neural and endocrine connections. A constellation of loss of satiety, reduction of metabolic rate, thermogenesis, and physical activity, and increased vagal tone and hyperinsulinism with insulin and leptin resistance results in rapid weight gain due to decreased energy expenditure and increased energy storage in adipose cells. To date, no viable long-term solution for hypothalamic syndrome has been found. Accordingly, multidisciplinary hypothalamus-sparing treatment strategies are warranted for prevention of additional treatment-related hypothalamic damage.

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  1. Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Klinikum Oldenburg AöR, Oldenburg, Germany

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Müller, H.L. (2020). Disease and Treatment-Related Hypothalamic Alterations in Craniopharyngioma: Clinical Presentation, Prognostic Impact, and Implications for Treatment Strategies. In: Jouanneau, E., Raverot, G. (eds) Adult Craniopharyngiomas. Springer, Cham. https://doi.org/10.1007/978-3-030-41176-3_10

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