Endocrine and metabolic consequences of childhood-onset craniopharyngioma during the transition age: A literature review by the TALENT study group
Abstract
Craniopharyngiomas are frequently diagnosed during childhood and adolescence, crucial periods for physical and psychosocial development. Despite improvements in survival rates, patients with childhood-onset craniopharyngioma face a wide array of lifelong complications, which emerge or worsen during adolescence, complicating the transition to adult care. Nevertheless, the transition age (15-25 years) remains an understudied phase in clinical practice. This narrative review synthesises current literature on the endocrine, neurocognitive, and metabolic consequences of transition-age childhood-onset craniopharyngiomas, providing a practical clinical approach to their diagnosis and management, along with an overview of emerging treatment strategies. Childhood-onset craniopharyngiomas are frequently associated with pituitary hormone deficiencies, which typically worsen post-treatment. While replacement protocols largely mirror those for adult patients, particular emphasis should be placed on patient education and optimal timing of treatment, especially regarding puberty induction and growth hormone replacement. Emerging therapies, such as long-acting growth hormone and modified-release hydrocortisone, should be considered to improve compliance. Hypothalamic dysfunction, both pre- and post-treatment, can lead to obesity, sleep disorders, and cognitive impairment. GLP-1 receptor agonists and melanocortin receptor agonists have recently shown promise in managing hypothalamic obesity.…
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