Endocrine manifestations of central nervous system germ cell tumors in children.

Autor: García García E; Servicio de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: ejgg67@gmail.com., Gómez Gila AL; Servicio de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, España., Merchante E; Servicio de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, España., Rivero Garvia M; Servicio de Neurocirugía, Hospital Universitario Virgen del Rocío, Sevilla, España., Venegas Moreno E; Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España., Soto Moreno A; Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España., Márquez Vega C; Servicio de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, España.
Jazyk: English; Spanish; Castilian
Zdroj: Endocrinologia, diabetes y nutricion [Endocrinol Diabetes Nutr (Engl Ed)] 2020 Oct; Vol. 67 (8), pp. 540-544. Date of Electronic Publication: 2020 Mar 18.
DOI: 10.1016/j.endinu.2019.11.012
Abstrakt: Introduction: Central nervous system germ cell tumors need to be adequately diagnosed because their treatment is usually effective and they do not always require surgery. The study objectives are to describe the endocrine manifestations of these tumors and to compare the time of their onset to that of the occurrence of neurological and visual changes.
Patients and Methods: The medical histories of patients under 14 years of age seen at a pediatric endocrinology unit between 2000 and 2018 were reviewed. Wilcoxon and Fisher statistical tests were performed.
Results: We found 12patients (10 females) with an age at diagnosis of 9.4±1.7 years and a follow-up time of 5.5±3.0 years, 10with tumors in the sellar region, and each one with a pineal gland and a bifocal tumor. Clinical changes leading to diagnosis were neurological and/or visual in 9patients and hormonal in three. Seven patients diagnosed on the basis of neurological or visual symptoms had previously reported hormonal changes, giving us a total of 10 children at diagnosis (the most common diagnosis was central diabetes insipidus, found in 8). Endocrine symptoms had been present before diagnosis for 25.0±26.2 months, considerably longer than neuro-ophthalmological complaints (2.0±2.1 months, p=0.012).
Conclusions: Almost all intracranial germ cell tumors have associated endocrine manifestations at diagnosis, with central diabetes insipidus the most common. Hormonal symptoms usually appear long before neuro-ophthalmological manifestations. Adequate clinical and endocrinological assessment may allow for an earlier diagnosis of these tumors.
(Copyright © 2020 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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