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The symptoms and results of treatment of craniopharyngioma are similar in children and adults
The background of the study. Craniopharyngiomas
are benign tumors that originate in the pituitary gland or the adjacent
brain (hypothalamus). They occur in both children and adults, and
they cause both hormonal and neurologic effects. In this study,
the clinical manifestations and results of treatment were compared
in children and adults with these tumors.
How the study was done. The study subjects were 121 patients with craniopharyngioma seen at a single hospital in the United Kingdom; 42 were <16 years old and 79 were older. Radiologic and hormonal studies were done at base line and periodically during follow-up.
The results of the study. The duration of symptoms before diagnosis ranged from 0.5 month to 20 years. Among the children, the most common symptoms were headaches, nausea or vomiting, decreased vision, growth failure, poor energy, or loss of appetite or weight loss. Among the adults, the most common symptoms were headaches, decreased vision, poor energy, impaired sexual function, nausea or vomiting, or lethargy; many of the women had menstrual disorders.
The tumor was partially or completely removed surgically in nearly all patients, and many were treated with radiation. The 5- and 10-year recurrence-free survival rates were 100 percent in the patients whose tumor was completely removed, whether or not they were treated with radiation. The rates were 82 and 77 percent, respectively, in patients who underwent incomplete surgery and were treated with radiation; and 47 and 38 percent, respectively, in those who underwent incomplete surgery and did not receive radiation. The rates were similar in children and adults. The 5- and 10-year rates of deficiencies of all pituitary hormones were high, and there were no differences between children and adults.
The conclusions of the study. Among children and adults with a craniopharyngioma, combined surgical and radiation therapy is the most effective treatment, but post-treatment hormonal deficiencies are common.
The original article. Karavitaki N, Brufani C,
Warner JT, Adams CB, Richards P, Ansorge O, Shine B, Turner HE,
Wass JA. Craniopharyngiomas in children and adults: systematic analysis
of 121 cases with long-term follow-up. Clin Endocrinol (Oxf) 2005;62:397-409.
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| Thyroid Digest Index | | | July 2005 Thyroid Digest |
