Craniopharyngioma history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
Craniopharyngiomas are slow growing, and symptoms often are present for a year or more before the diagnosis is established. A wide range of symptoms may be present, depending upon the precise location of the tumor and its relationship to adjacent normal structures. Most common symptoms of craniopharyngioma include headache, nausea, vomiting, ataxia, polyuria, polydipsia, stunted growth, decreased libido, amenorrhea, weight gain, myxedema, vision loss, behavioral and learning problems.
Symptoms
Craniopharyngioma causes symptoms by:[1]
- Increasing pressure on the brain, usually from obstructive hydrocephalus: [2]
- Disrupting hormone production by the pituitary gland:
- Polyuria
- Polydipsia
- Stunted growth, leading to short stature
- Delayed puberty in children
- Decreased libido
- Amenorrhea
- Weight gain
- Myxedema
- Pressure or damage to the optic nerve: [2]
- Vision loss (bitemporal hemianopsia) [3]
- 20% of children and 80% of adults with craniopharyngioma have visual defects.
- These defects are often permanent, and may get worse after surgical removal of the tumor. [3]
- Behavioral and learning problems may be present, due to frontal and temporal extension
Visual symptoms
- Visual symptoms are frequent, and deficits on formal ophthalmologic assessment are present in the majority of patients. [2]
- Symptoms can be a direct result of pressure on the optic chiasm.
- The specific deficit depends upon the growth pattern of the tumor.
Endocrine abnormalities
- Direct damage to or compression of normal structures can lead to a range of endocrine abnormalities.
- Most frequently observed complications include deficiencies of growth hormone, gonadotropin, thyroid stimulating hormone, and adrenocorticotropic hormone.
- Diabetes insipidus is frequent when the pituitary stalk is involved. [3]
- Growth failure, which can be caused by either hypothyroidism or growth hormone deficiency.
- Sexual dysfunction is the most common endocrine manifestation in adults.
- 90% of men complain of erectile dysfunction, while most women have amenorrhea.[4]
Headache
- Headaches are present in approximately 50 percent of patients at the time of diagnosis. [5]
- Headaches may result from traction on pain-sensitive structures by the tumor itself, obstructive hydrocephalus from tumor compression of the third ventricle, or meningeal irritation by escaped cyst contents.[6]
Rare symptoms
- Craniopharyngiomas can also cause other generalized symptoms, such as depression, independent of any hormone deficiency.[2]
- The presumed cause is extension of tumor into the frontal lobes, striatal and thalamic areas, or limbic system.
- Nausea, vomiting, and lethargy can accompany pressure-related headaches in craniopharyngioma.[3]
References
- ↑ Symptoms of Craniopharyngioma. National library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000345.htm
- ↑ 2.0 2.1 2.2 2.3 Duff J, Meyer FB, Ilstrup DM, Laws ER, Schleck CD, Scheithauer BW (February 2000). "Long-term outcomes for surgically resected craniopharyngiomas". Neurosurgery. 46 (2): 291–302, discussion 302–5. PMID 10690718.
- ↑ 3.0 3.1 3.2 3.3 Khan RB, Merchant TE, Boop FA, Sanford RA, Ledet D, Onar-Thomas A, Kun LE (December 2013). "Headaches in children with craniopharyngioma". J. Child Neurol. 28 (12): 1622–5. doi:10.1177/0883073812464817. PMC 4264380. PMID 23143722.
- ↑ Cohen LE (August 2016). "Update on childhood craniopharyngiomas". Curr Opin Endocrinol Diabetes Obes. 23 (4): 339–44. doi:10.1097/MED.0000000000000264. PMID 27258775.
- ↑ Müller HL (June 2014). "Craniopharyngioma". Endocr. Rev. 35 (3): 513–43. doi:10.1210/er.2013-1115. PMID 24467716.
- ↑ Wijnen M, van den Heuvel-Eibrink MM, Janssen J, Catsman-Berrevoets CE, Michiels E, van Veelen-Vincent MC, Dallenga A, van den Berge JH, van Rij CM, van der Lely AJ, Neggers S (June 2017). "Very long-term sequelae of craniopharyngioma". Eur. J. Endocrinol. 176 (6): 755–767. doi:10.1530/EJE-17-0044. PMID 28325825. Vancouver style error: initials (help)