SAT-101 - Metabolic and Endocrinological Disorders in Patients with Craniopharyngioma: A Retrospective Cohort Study from A University-Based Tertiary Hospital

Introduction: Craniopharyngiomas (CPs) are rare sellar/suprasellar tumors arising from Rathke’s pouch remnants. They account for 1.2–4.6% of intracranial tumors, frequently involving the hypothalamic–pituitary axis, leading to severe endocrine and metabolic complications known as hypothalamic syndrome, with significant morbidity, mortality, and impaired quality of life. Objectives and

Methods: Cross-sectional, descriptive study based on retrospective analysis of medical records of adult patients with CP followed at the Neuroendocrinology clinic of a tertiary University hospital (2017-2025) The aim was to describe demographic, hormonal, and metabolic profile of the evaluated patients. Anthropometric data, lipid and glycemic profiles, blood pressure, Triglyceride–Glucose index (TyG), Lipid Accumulation Product (LAP), pituitary hormone deficiencies, and comorbidities were analyzed.

Results: Thirty-one patients were included; 64.5% were male. Mean±SD age at last evaluation and at diagnosis was 41.5±17.2 years and 24.5±18.2 years, respectively, without a clear bimodal distribution. Adult-onset CP (51.6%) and adamantinomatous subtype (80%) predominated, with a single case of the papillary subtype. Tumors were mostly suprasellar or mixed sellar/suprasellar, with a mean initial size of 3.1±1.67 cm. Surgery was performed in 96.7% of patients (transcranial in 66.6% and transsphenoidal in 33.3%). Reoperation was required in 26.7%, and radiotherapy was administered to 22.5% of patients. Mean±SD BMI was 31.4±8.4 kg/m²; 71.4% had increased waist circumference and 85.7% had waist-to-height ratio ≥0.5. Metabolic syndrome was present in 57.1% while type 2 Diabetes Mellitus was present in 22.5%. Hypertriglyceridemia was identified in 55.5% and LDL-C ≥115 mg/dL in 44.4%. LAP and TyG were elevated in 71.4% and 61.5%, respectively. Hypertension was present in 25.8% of the patients. Combined pituitary hormone deficiency was observed in 93.5%, with 35.4% of the patients presenting deficiency in all five axes. Other comorbidities included epilepsy (25.8%), psychiatric disorders (16.1%), and low bone mass/osteoporosis (29.0%). Two deaths occurred, both among patients with childhood onset CP, related to late complications of the disease and its treatment.

Conclusion: Adults followed for CP exhibit a high burden of obesity, dysmetabolism, and multiple pituitary deficits, consistent with hypothalamic syndrome as a key driver of long-term morbidity. These findings broaden the understanding of the clinical spectrum of CP, supporting the need for prospective studies to elucidate long-term outcomes and optimize care strategies for this population.

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