Abstract
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.