Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- perda da visão
- macrocefalia e hidrocefalia
- deficit de crescimento
Outros fatores diagnósticos
- sintomas de hipogonadismo hipogonadotrófico (amenorreia, disfunção erétil)
- cefaleia
- sintomas de hipertensão intracraniana (náuseas, vômitos, diminuição do sensório, diplopia)
- galactorreia
- atrofia óptica
- poliúria/polidipsia
Fatores de risco
- idade entre 5 e 14 anos
- idade entre 50 e 70 anos
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- avaliação oftalmológica; exame computadorizado de campo visual
- ressonância nuclear magnética (RNM) cranioencefálica (com contraste)
- tomografia computadorizada (TC) cranioencefálica (com contraste)
- prolactina sérica
- hormônio do crescimento (GH) sérico
- fator sérico de crescimento semelhante à insulina 1 (IGF-1)
- proteína 3 de ligação do fator de crescimento semelhante à insulina (IGFBP-3)
- testes de provocação do hormônio do crescimento (GH)
- hormônio luteinizante sérico
- hormônio folículo-estimulante sérico
- testosterona sérica matinal
- hormônio estimulante da tireoide sérico e T3/T4
- cortisol sérico matinal e hormônio adrenocorticotrófico (ACTH)
- eletrólitos séricos
- osmolalidade sérica e da urina
- densidade urinária
- radiografia simples para idade óssea
Investigações a serem consideradas
- histologia de tecido
Algoritmo de tratamento
no tratamento inicial
tratamento pós-inicial
Colaboradores
Autores
Marc C. Chamberlain, MD
Chief
Division of Neuro-Oncology
Department of Neurology and Neurological Surgery
University of Washington
Seattle Cancer Care Alliance
Seattle
WA
Declarações
MCC declares that he has no competing interests.
Agradecimentos
Dr Marc C. Chamberlain would like to gratefully acknowledge Dr Daniel L. Silbergeld, a previous contributor to this topic.
Disclosures
DLS declares that he has no competing interests.
Peer reviewers
Larry Junck, MD
Professor of Neurology
Department of Neurology
University of Michigan
Ann Arbor
MI
Disclosures
LJ declares that he has no competing interests.
Jeff Raizer, MD
Associate Professor of Neurology
Director of Medical Neuro-Oncology
Northwestern University
Chicago
IL
Disclosures
JR declares that he has no competing interests.
Ramez Kirollos, MBChB, FRCS(Ed), FRCS(Eng), MD, FRCS(SN)
Consultant Neurosurgeon
Addenbrooke's Hospital
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
Disclosures
RK declares that he has no competing interests.
Keyoumars Ashkan, BA, BSc, MB BCh, MRCP, FRCS, FRCPS, FRCS(SN), MD
Consultant Neurosurgeon and Lead of Neuro-Oncology
King's College Hospital
London
UK
Disclosures
KA declares that he has no competing interests.
Edwin S. Kulubya Jr., MD, MBA
Neurosurgical Research Fellow
UC Davis Medical Center
Sacramento
CA
Disclosures
EK declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Garre ML, Cama A. Craniopharyngioma: modern concepts in pathogenesis and treatment. Curr Opin Pediatr. 2007 Aug;19(4):471-9. Abstract
Puget S, Garnett M, Wray A, et al. Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg. 2007 Jan;106(1 suppl):3-12. Abstract
Minniti G, Saran F, Traish D, et al. Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas. Radiother Oncol. 2007 Jan;82(1):90-5. Abstract
Dekkers OM, Biermasz NR, Smit JW, et al. Quality of life in treated adult craniopharyngioma patients. Eur J Endocrinol. 2006 Mar;154(3):483-9.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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