Retrospective Analysis of Growth in Tumors of Hypothalamus-Hypophysis
Region
Koloušková S.1, Zemková D.1, Cháňová M.2, Mališ J.2, Šnajderová M.1
Pediatrická klinika 2. LF UK a FN Motol, Praha1 přednosta prof. MUDr. J. Vavřinec, CSc. Klinika dětské hematologie a onkologie 2. LF UK a FN Motol, Praha2 přednosta prof. MUDr. J. Starý, DrSc. |
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Summary:
Objective: Analysis of symptoms leading to the diagnosis of brain tumor in hypothalamushypophysis
region and the occurrence of growth retardation according to retrospective analysis
of growth.
Patients and methods: The authors analyzed a group of 70 patients (37 girls and 33 boys) at the
mean age of 9.7±3.8 (0.8–17) years with tumors in hypothalamic-hypophysis region: 32 children
with craniopharyngioma (13 girls, 19 boys), 18 children with astrocytoma (14 girls, 4 boys) and 20
children with germinal tumors (10 boys and 10 girls).
Results: Although the growth retardation was the reason for examination in 6% of children
only (4), the retrospective analysis established growth retardation in 51.4% of children (36/70).
The height below 3rd percentile was observed in 27.1% of children (19/70). In the cases suffering
from craniopharyngioma the growth retardation occurred in 68.6% (22/32) patients, the growth
below the 3rd percentile being found in 37.5% (12/32) children. The children with germinal tumor
were affected by growth retardation in 55 % of cases (11/20) and in 10 of them (50%) the growth
was below the 3rd percentile. In patients affected by astrocytoma the growth retardation was
established in 16% of children (3/19), while the growth below the 3rd percentile was absent in all
of them. The growth retardation related to the hereditary potential was apparent in all groups.
The mean height of the parents against the height of the patient at the time of diagnosis establishment proved to be -0.01±0.94 SD vs. -1.7±1.3 SD in the children with craniopharyngioma
(p<0.001), -0.29±0.8 SD vs. -1.67±1.66 SD in children with germinal tumors (p<0.01) and 0±0.78 vs.
-0.68±0.95 SD in children with astrocytoma (p<0.05). The decrease of growth rate in the patients
with growth retardation was detectable at least two years before diagnosis of the tumors (range
2–8 years).
Conclusion: A careful monitoring of growth of the child and a comparison with the height with
the predictive range according to the parents made in possible to diagnose the tumor in our
cohort of children at an earlier time in more than 50% of patients.
Key words:
tumors of hypothalamo-hypophysis region, retrospective analysis of growth
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