Endocrine findings in patients with optico-hypothalamic gliomas.
OBJECTIVE
Optico-hypothalamic gliomas (OHG) are an important differential diagnosis in suprasellar tumors. Visual impairment and hydrocephalus are the most frequent findings at presentation. However, only limited data are available about endocrine disturbances in these lesions.


METHODS
38 consecutive patients (19 children) were studied retrospectively. Clinical assessment and endocrinological evaluation of pituitary and hypothalamic functions (combined pituitary stimulation test, ITT, CRH-GRH test) were performed before and after (1 week and 3 months) the neurosurgical procedure.


RESULTS
Only three patients showed clinical features of endocrine deficiency initially. 16 children and 15 adults out of the 38 patients (31/38, 81.6 %) showed no abnormality in their hormone values when assessed with the combined pituitary stimulation test alone or using more sophisticated investigations such as ITT and CRH-GRH test (72.2 %). Patients with hypothalamic disturbances (8 out of 38, 21 %) had endocrine abnormalities more frequently than those without (57.1 % vs. 9 %, p < 0.05), as assessed by ITT and CRH-GRH-test.


CONCLUSIONS
In contrast to other suprasellar tumors, endocrine deficiencies are surprisingly rare in optico-hypothalamic gliomas despite their large size, especially in the absence of hypothalamic disorders. This may be used as a criterion in the differential diagnosis of these lesions, in addition to the radiological findings.
Martínez
R
R
Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany. rmartinez3108@hotmail.com
Honegger
J
J
Fahlbusch
R
R
Buchfelder
M
M
D000293:Adolescent; D000375:Aging; D002648:Child; D003131:Combined Modality Therapy; D004702:Endocrine Glands / Q000503:physiopathology*; D005260:Female; D005910:Glioma / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D019574:Optic Nerve Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D011184:Postoperative Period; D011300:Preoperative Care; D011878:Radiotherapy; D012189:Retrospective Studies