Craniopharyngioma Across the Lifespan: A Large Single-Center Cohort Study of Surgical Outcomes, Endocrine Morbidity, and Long-Term Disease Control
7 affiliations
- 1Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- 2Department of Endocrinology, Indus International Hospital, Derabassi, Punjab, India
- 3Department of Endocrinology, My Hospital, Sector 69, Mohali, Punjab, India
- 4Department of Biochemistry, Panjab University, Chandigarh, India
- 5Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- 6Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- 7Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, India
Abstract
Objective: Craniopharyngiomas are rare epithelial tumors of the sellar–suprasellar region associated with significant neurologic, endocrine, and metabolic morbidity. Long-term outcome data across the lifespan from low- and middle-income settings remain limited. We aimed to characterize clinical presentation, surgical outcomes, endocrine morbidity, mortality, long-term disease control, and the safety of growth hormone therapy.
Methods: This retrospective observational study included patients with histologically confirmed craniopharyngioma managed at a tertiary-care center. Clinical, biochemical, radiologic, surgical, histopathologic, and follow-up data were analyzed. Tumors were classified as adamantinomatous or papillary. Surgical approaches, complications, tumor progression, endocrine outcomes, retreatment, mortality, and growth hormone therapy-related outcomes were evaluated.
Results: A total of 274 patients were included (266 adamantinomatous, 8 papillary), with a median age at diagnosis of 16 years (range, 1-75 years). Headache or symptoms of increased intracranial pressure (88.0%) and visual impairment (77.4%) were the most common presenting features. Preoperative anterior pituitary dysfunction was present in 81.5% of patients. Median tumor volume was 17.0 cm3, with 20% classified as giant tumors. Residual or progressive disease occurred in 62.6% of patients, and 32.1% required retreatment. Postoperative anterior pituitary deficiency occurred in 98.1% and immediate postoperative arginine vasopressin deficiency in 90.1% of patients, and obesity was frequent during follow-up. Tumor progression did not differ between surgical approaches; however, cerebrospinal fluid-related complications were more frequent after transsphenoidal surgery. Thirty-three deaths occurred during follow-up. Rare presentations included cerebellar ataxia, bobble-head doll syndrome, malignant transformation, ectopic tumors, inflammatory pituitary pathology, and refractory disease.
Conclusion: Craniopharyngioma is associated with substantial lifelong morbidity despite benign histology. Multidisciplinary, risk-adapted management strategies prioritizing functional preservation and long-term endocrine care are essential.
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BibTeX
@article{jha2026craniopharyngioma,
title = {{Craniopharyngioma Across the Lifespan: A Large Single-Center Cohort Study of Surgical Outcomes, Endocrine Morbidity, and Long-Term Disease Control}},
author = {Vivek Jha and Anand Sudhay and Ashutosh Rai and Debajyoti Chatterjee and Uma Nahar Saikia and Shivasanmugam Dhandapani and Sandeep Mohindra and S.K. Sahoo and Apinderpreet Singh and Mohammed Safeer V.S and Manjul Tripathi and Vaishali Kaur and Amal Shaharyar and Pravin Salunke and Pinaki Dutta},
journal = {AACE Endocrinology and Diabetes},
year = {2026},
month = aug,
doi = {10.1016/j.aed.2026.07.015},
url = {https://doi.org/10.1016/j.aed.2026.07.015},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Craniopharyngioma Across the Lifespan: A Large Single-Center Cohort Study of Surgical Outcomes, Endocrine Morbidity, and Long-Term Disease Control
AU - Vivek Jha
AU - Anand Sudhay
AU - Ashutosh Rai
AU - Debajyoti Chatterjee
AU - Uma Nahar Saikia
AU - Shivasanmugam Dhandapani
AU - Sandeep Mohindra
AU - S.K. Sahoo
AU - Apinderpreet Singh
AU - Mohammed Safeer V.S
AU - Manjul Tripathi
AU - Vaishali Kaur
AU - Amal Shaharyar
AU - Pravin Salunke
AU - Pinaki Dutta
PY - 2026
DA - 2026/08/03
JO - AACE Endocrinology and Diabetes
DO - 10.1016/j.aed.2026.07.015
UR - https://doi.org/10.1016/j.aed.2026.07.015
AB - Objective: Craniopharyngiomas are rare epithelial tumors of the sellar–suprasellar region associated with significant neurologic, endocrine, and metabolic morbidity. Long-term outcome data across the lifespan from low- and middle-income settings remain limited. We aimed to characterize clinical presentation, surgical outcomes, endocrine morbidity, mortality, long-term disease control, and the safety of growth hormone therapy. Methods: This retrospective observational study included patients with histologically confirmed craniopharyngioma managed at a tertiary-care center. Clinical, biochemical, radiologic, surgical, histopathologic, and follow-up data were analyzed. Tumors were classified as adamantinomatous or papillary. Surgical approaches, complications, tumor progression, endocrine outcomes, retreatment, mortality, and growth hormone therapy-related outcomes were evaluated. Results: A total of 274 patients were included (266 adamantinomatous, 8 papillary), with a median age at diagnosis of 16 years (range, 1-75 years). Headache or symptoms of increased intracranial pressure (88.0%) and visual impairment (77.4%) were the most common presenting features. Preoperative anterior pituitary dysfunction was present in 81.5% of patients. Median tumor volume was 17.0 cm3, with 20% classified as giant tumors. Residual or progressive disease occurred in 62.6% of patients, and 32.1% required retreatment. Postoperative anterior pituitary deficiency occurred in 98.1% and immediate postoperative arginine vasopressin deficiency in 90.1% of patients, and obesity was frequent during follow-up. Tumor progression did not differ between surgical approaches; however, cerebrospinal fluid-related complications were more frequent after transsphenoidal surgery. Thirty-three deaths occurred during follow-up. Rare presentations included cerebellar ataxia, bobble-head doll syndrome, malignant transformation, ectopic tumors, inflammatory pituitary pathology, and refractory disease. Conclusion: Craniopharyngioma is associated with substantial lifelong morbidity despite benign histology. Multidisciplinary, risk-adapted management strategies prioritizing functional preservation and long-term endocrine care are essential.
SN - 3050-9157
ER -