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Hypothalamic‐pituitary dysfunction in patients with craniopharyngioma
Author(s) -
Paja M.,
Lucas T.,
GarcíaUria J.,
Salamé F.,
Barceió B.,
Estrada J.
Publication year - 1995
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1995.tb02664.x
Subject(s) - craniopharyngioma , diabetes insipidus , medicine , endocrinology , endocrine system , anterior pituitary , hypothalamic disease , basal (medicine) , pituitary stalk , thyroid function , hypopituitarism , pituitary gland , pituitary neoplasm , hormone , diabetes mellitus , hypogonadotropic hypogonadism
Summary OBJECTIVE Previous studies of preoperative pituitary function in patients with craniopharyngioma have been limited in scope and have focused on children. We have evaluated the impact of craniopharyngiomas and their surgical treatment on pituitary function In a large group of mostly adult patients. DESIGN We performed a retrospective study of patients treated at our centre between 1980 and 1992. PATIENTS Twenty‐two men and 13 women, most of them adults, treated surgically for craniopharyngioma during the above period. MEASUREMENTS Serum glucose, GH, LH, FSH, TSH and Cortisol were measured both before and after a combined insulin induced hypoglycaemia, GnRH and TRH test. Basal concentrations of thyroid hormones, PRL and gonadal steroids were also measured. Preoperative computed tomographic scan was performed in all patients, and a detailed study of visual function before and after surgery was available for 32 of them. Endocrine function was reevaluated post‐operatively. RESULTS In preoperative studies, 29 patients had some anterior pituitary deficit and 13 had diabetes insipidus. The most common abnormality was gonadotrophin deficiency, followed by GH deficiency. Dynamic studies suggested a hypothalamic origin for these deficits. In post‐surgical evaluation, Impaired pituitary function was observed in most patients. Panhypopituitarism was present in 28 cases and diabetes insipidus in 24. CONCLUSIONS Our report illustrates the high Incidence of endocrine deficits in patients with craniopharyngioma. Additional hypothalamic‐pituitary dysfunction usually occurs following surgical treatment of these tumours.