Craniopharyngiomas: Clinical Presentation and Endocrinological Evaluation.

Abstract

Ten patients with craniopharyngioma were studied in three years period. There were nine (90%) males and one (10%) female. Age of these patients ranged from 2-58 years. The major clinical features were headache (70%), deterioration of vision (70%) in the form of decreased visual acuity and field defects. Endocrinopathies were present in the form of short statured ness (40%),underdevelopment of secondary sex characters (40%), loss of libido and impotence (20%). Endocrinological evaluation revealed Gonadotrophin deficiency in 50% pituitary thyroid axis deficiency in 40% and serum cortisol deficiency in 40% patients. Eight percent patients had Hyperprolactinemia, Growth hormone levels were found within normal range. On CT scan, only 20% patients had calcification, ninety percent patients had tumors in suprasellar region and 30% had parasellar extension. Sixty percent lesions were cystic and 40% were mixed-density lesions. Transcranial subfrontal approach was adopted and surgery was done under the microscope. In six patients total removal was possible and in the remaining four patients where total removal was not possible, postoperative radiotherapy was advised. The patients with hypopituitarism were given hormone replacement therapy accordingly.