Novel clinical algorithm for hypothalamic obesity in youth with brain tumours and factors associated with excess weight gain

Rydin, Amy A; Severn, Cameron; Pyle, Laura; Dorris, Kathleen; Chambers, Christina D.; Stiller, Debra; Hankinson, Todd C.; Inge, Thomas H.; Haemer, Matthew; Mirsky, David M.; Kelsey, Megan M.

doi:10.1111/ijpo.12903

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…Preservation of visual and pituitary function, when possible, as well as avoiding injury to critical skull base vasculature is also integral to decision making. While compression of the optic apparatus can often be relieved with surgical intervention, and pituitary hormones can be supplemented or replaced, hypothalamic dysfunction is not only life altering, but exceedingly difficult to treat 135,146,[149][150][151] . However, given the more advanced developmental stage of the adult brain, in adult patients with CP, especially those with PCP or less cystic ACP -more aggressive surgery may be indicated 152 .…”

Section: Goals Of Surgerymentioning

confidence: 99%

Contemporary Biological Insights and Clinical Management of Craniopharyngioma

et al. 2022

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Craniopharyngiomas are clinically aggressive tumours due to their invasive behaviour and recalcitrant tendency to recur after therapy. There are two types based on their distinct histology and molecular features: The papillary craniopharyngioma (PCP), which is associated with BRAF-V600E mutations and the adamantinomatous craniopharyngioma (ACP), characterised by mutations in CTNNB1 (encoding β-catenin). Patients with craniopharyngioma show symptoms linked to the location of the tumour close to the optic pathways, hypothalamus and pituitary gland, such as increased intracranial pressure, endocrine deficiencies and visual defects. Treatment is not specific and mostly non-curative, and frequently includes surgery, which may achieve gross-total or partial resection, followed by radiotherapy. In cystic tumours, frequent drainage is often required and intracystic instillation of drugs has been used to help manage cyst refilling. More recently targeted therapies have been used, particularly in papillary craniopharyngioma, but also now in adamantinomatous craniopharyngioma and clinical trials are underway or in development. Although patient survival is high, the consequences of the tumour and its treatment can lead to severe comorbidities resulting in poor quality of life, in particular for those patients that bear tumours with hypothalamic involvement. Accordingly, in these patients at risk for the development of a hypothalamic syndrome hypothalamus-sparing treatment strategies such as limited resection followed by irradiation are recommended. In this review, we provide an update on various aspects of craniopharyngioma, with emphasis on recent advances in the understanding of tumour pathogenesis, clinical consequences, management and therapies.

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Section: Goals Of Surgerymentioning

confidence: 99%

Contemporary Biological Insights and Clinical Management of Craniopharyngioma

et al. 2022

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Physiological and environmental factors affecting cancer risk and prognosis in obesity

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Kamdje³

et al. 2023

Seminars in Cancer Biology

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Approach to the Patient With Hypothalamic Obesity

Tamaroff

2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Hypothalamic obesity (HO) is defined as abnormal weight gain due to physical destruction of the hypothalamus. Suprasellar tumors, most commonly craniopharyngiomas, are a classic cause of HO. HO often goes unnoticed initially as patients, families and medical teams are focused on oncologic treatments and management of panhypopituitarism. HO is characterized by rapid weight gain in the first year after hypothalamic destruction followed by refractory obesity due to an energy imbalance of decreased energy expenditure without decreased food intake. Currently available pharmacotherapies are less effective in HO than in common obesity. While not a cure, dietary interventions, pharmacotherapy, and bariatric surgery can mitigate the effects of HO. Early recognition of HO is necessary to give an opportunity to intervene before significant weight gain occurs. Our goal for this article is to review the pathophysiology of HO and to discuss available treatment options and future directions for prevention and treatment.

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Novel clinical algorithm for hypothalamic obesity in youth with brain tumours and factors associated with excess weight gain

Cited by 4 publications

References 37 publications

Contemporary Biological Insights and Clinical Management of Craniopharyngioma

Contemporary Biological Insights and Clinical Management of Craniopharyngioma

Physiological and environmental factors affecting cancer risk and prognosis in obesity

Approach to the Patient With Hypothalamic Obesity

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