Clinical Characteristics and Postoperative Growth in Japanese Children with Craniopharyngioma.

OBJECTIVE

Craniopharyngioma (CP) has mostly nonspecific symptoms, leading to delayed diagnosis. Early indicators of CP in children are needed for early diagnosis and to detect postoperative growth patterns for their optimal care. This study aimed to investigate the clinical characteristics and postoperative growth patterns in Japanese children with CP.

DESIGN

Retrospective analysis of medical records (2000-2022).

METHODS

Seventy-three children (median age at diagnosis = 9.3 (0.9-18) years; 44 females) from Toranomon Hospital, Tokyo, Japan, who were diagnosed with CP and undergoing trans-sphenoidal or trans-cranial surgery, or both, were followed up for at least 3 years. We assessed clinical characteristics and changes in height and body mass index (BMI) standard deviation scores (SDSs).

RESULTS

The SDSs for height and BMI were -1.7 (-4.0 to 1.3) and 0.21 (-2.3 to 2.2), respectively. Chief complaints at diagnosis were neurologic (n = 25, 34.2%), endocrine (n = 22, 30.1%), or ophthalmic (n = 22, 30.1%), while accompanying neurologic, endocrine, and ophthalmic symptoms were present in 34 (46.6%), 63 (86.3%), and 37 (50.7%) patients, respectively. One year after surgery, growth without growth hormone (GWGH) was detected in seven patients (13%), which could be categorized based on MRI-evident hypothalamic involvement (transient: n = 3, 5.6%; permanent: n = 4, 7.4%). Preoperative hydrocephalus (n = 21, 32.8%) was the only factor significantly associated with postoperative GWGH at 1 year (p = 0.037).

CONCLUSION

Children with CP have distinctive clinical characteristics and postoperative growth patterns. Identifying symptoms using school-based auxological measurements could help in early diagnosis.