Factors related to endocrine changes and hormone substitution treatment during pre- and post-operation stages in craniopharyngioma

Abstract

Factors related to endocrine changes and hormone substitution treatment during pre- and post-operation periods in craniopharyngioma cases were examined. Twenty patients who underwent tumor resection from January 2012 to January 2015 were included in the study. We monitored factors related to endocrine changes and hormone substitution treatment during pre- and post-operation periods. Blood thyroid-stimulating hormone, triiodothyronine, thyroxine, prolactin, follicle-stimulating hormone, luteinizing hormone and cortisol levels were measured in the patients. Urinary volume and urine specific gravity were also measured before and after the operation. After the operation, we observed diabetes insipidus and a decrease in TSH and gonadal hormone levels more frequently compared to pre-operation. However, incidence of high prolactin was markedly reduced following surgery. The number of hypothyroidism cases before and after surgery had no statistical significance. In conclusion, surgery for craniopharyngioma aggravated endocrine dysfunction. Craniotomy and total tumor resection had considerable effects on the endocrine system. Routine hormone therapy as an alternative treatment was necessary after operation. Alternative treatment of adrenal cortex hormones reduced the incidence on low blood cortisol.

Hyperprolactinaemia

“…Any lesion leading to interruption of the dopaminergic pathways due to compression of the pituitary stalk and portal vessels can lead to hyperprolactinaemia through the "stalk effect" [including pituitary adenomas with the most common cause in this setting being the non-functioning pituitary adenomas (NFA); parasellar tumours (such as Rathke's cleft cyst, craniopharyngioma, meningioma or germinoma); metastatic pituitary disease, infiltrative/inflammatory diseases (such as lymphocytic hypophysitis, Langerhans cell histiocytosis, and sarcoidosis)] [6,25,41]. Stalk compression from NFA or other parasellar tumours is typically associated with PRL levels <100 µg/L [42,43].…”

Endocrine Disorder in Patients With Craniopharyngioma

“…Adrenocortical dysfunction may greatly impact the rehabilitation of patients, and the hormone replacement therapy is a key step in craniopharyngioma treatment ( 68 ). Although the corticosteroid replacement therapy reduces the incidence of hypocortisol ( 51 ), risks are concurrently observed. It is stated that in patients with ACTH deficiency, a daily dose of more than 25 mg hydrocortisone is linked to increased mortality compared to lower doses ( 69 ).…”