Epidemiological characteristics, treatment and its outcomes in children presenting with craniopharyngioma at a tertiary care center

Introduction: Craniopharyngiomas are benign midline intracranial tumors commonly seen in pediatric population. They constitute approximately 10% of primary brain tumors in children which can cause considerable morbidity and mortality due to local aggressiveness of tumor itself or its treatment effecting hypothalamo-pituitary axis, visual defects, and effects of raised intracranial pressure The aim of this study is to report the characteristics of epidemiological features of pediatric patients with craniopharyngioma from our part of the world, treatment modality used in managing and to highlight the outcomes. Methodology: A Retrospective review of the records of children aged 1-18 years diagnosed with craniopharyngioma presenting between 2010 to 2020 was done Results: Out of total 44 files reviewed, 52% were male and 48% were female, the mean age of presentation was 11.2 years, the most common presenting features were headache, visual defects and vomiting (80%,75%,50%). In 38 children (86%) tumor was removed through transcranial approach, while in 6 (14%) transsphenoidal technique was used. In 11 (25%) omaya reservoir was placed for interferon therapy out of which 5 patients underwent for debulking surgery due to disease progression. Overall 12(27%) patients were retreated for relapse. Only two patient received radiotherapy. There was a high incidence of postoperative thyrotrophin deficiency 38(86%), diabetes insipidus 36(81%) followed by adrenocorticotropin deficiency, growth hormone, and gonadotrophin deficiency 68%,45%,45% respectively. Majority of patients developed post-operative panhypopituitarism.Conclusion: We found that the incidence of craniopharyngioma is more common in adolescent age group with male predominance. Transcranial approach is the modality of choice for majority of surgeons. The most frequent endocrine complication observed in our was hypothyroidism followed by diabetes insipidus