S2926 Craniopharyngioma-Induced Hypothalamic Obesity and a Red Herring Known as Binimetinib

Cholecystokinin (CCK) is a gut peptide whose proposed effect on satiety is thought to be related to gastric volume and to be signaled through vagal afferent fibers to the medial hypothalamus. To test these hypotheses we infused CCK C-terminal octapeptide (CCK-8) or saline in a random double-blind fashion in three groups of subjects: 17 obese subjects, 6 of whom subsequently received a gastric bubble, and 5 obese subjects whose obesity was due to hypothalamic injury. The number of sandwich canapes eaten after saline or CCK-8 infusion was recorded during three consecutive 10-min eating periods. Each subject served as his/her own control. The prior infusion of CCK-8 significantly decreased the consumption of sandwich canapes in the first eating period in both the control obese subjects and the subjects with obesity due to hypothalamic injury. Insertion of a gastric bubble did not enhance the satiety effect of CCK-8. These studies support the hypothesis that CCK produces satiety in a time-dependent manner that is not enhanced after the insertion of a gastric bubble but is operative in obese subjects with hypothalamic injury.

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RARE-59. CARDIAC REMODELING IN PATIENTS WITH CHILDHOOD-ONSET CRANIOPHARYNGIOMA – RESULTS OF HIT-ENDO AND KRANIOPHARYNGEOM 2000/2007

Neuro-Oncology ◽

10.1093/neuonc/noaa222.769 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii455-iii455

Author(s):

Panjarat Sowithayasakul ◽

Leona Katharin Buschmann ◽

Svenja Boekhoff ◽

Hermann L Müller

Keyword(s):

Cardiac Remodeling ◽

Disease Duration ◽

Interventricular Septum ◽

Left Ventricular ◽

Internal Diameter ◽

Functional Impairments ◽

Childhood Onset ◽

Anthropometric Parameters ◽

Hypothalamic Obesity ◽

Wide Range

Abstract BACKGROUND Hypothalamic obesity caused by childhood–onset craniopharyngioma results in long–term cardiovascular morbidity. Knowledge about clinical markers and risk factors is rare. PATIENTS AND METHODS A cross–sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 patients with childhood-onset adamantinomatous craniopharyngioma. RESULTS Body mass index (BMI) correlated with the thickness of interventricular septum in diastole (IVSd) (r=0.604, p<0.001) and left ventricular diastolic posterior wall in diastole (LVPWd) (r=0.460, p=0.011). Due to wide range of disease duration, 17 pediatric and 19 adult patients were analyzed separately. In the adult subgroup (age at study ≥18 years), BMI correlated with IVSd (r=0.707, p=0.003), LVPWd (r=0.592, p=0.020) and left ventricular internal diameter in diastole (LVIDd) (r=0.571, p=0.026). In the pediatric subgroup (age at study <18 years), no correlation between cardiac parameters and BMI was observed. Only LVIDd correlated with disease duration (r=0.645, p<0.001). All cardiac functions were within the normal range, indicating no association with severe functional impairments. CONCLUSIONS Cardiac remodeling in patients with childhood-onset craniopharyngioma correlates with the degree of hypothalamic obesity and disease duration. However, echocardiography has limited sensitivity in craniopharyngioma patients with obesity, so cardiac magnetic resonance imaging (MRI) should be considered as an alternative diagnostic approach for patients with craniopharyngioma and hypothalamic obesity.

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A Review of Childhood and Adolescent Craniopharyngiomas With Particular Attention to Hypothalamic Obesity

Pediatric Neurology ◽

10.1016/j.pediatrneurol.2013.09.003 ◽

2014 ◽

Vol 50 (1) ◽

pp. 4-10 ◽

Cited By ~ 24

Author(s):

Amy Rosenfeld ◽

Daniel Arrington ◽

Jeffrey Miller ◽

Micah Olson ◽

Annie Gieseking ◽

...

Keyword(s):

Hypothalamic Obesity

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Functional Neuroimaging in Craniopharyngioma: A Useful Tool to Better Understand Hypothalamic Obesity?

Obesity Facts ◽

10.1159/000338695 ◽

2012 ◽

Vol 5 (2) ◽

pp. 243-253 ◽

Cited By ~ 19

Author(s):

Christian L. Roth ◽

Elizabeth Aylward ◽

Olivia Liang ◽

Natalia M. Kleinhans ◽

Gregory Pauley ◽

...

Keyword(s):

Functional Neuroimaging ◽

Hypothalamic Obesity

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Post-operative hypothalamic lesions and obesity in childhood craniopharyngioma: results of the multinational prospective trial KRANIOPHARYNGEOM 2000 after 3-year follow-up

Acta Endocrinologica ◽

10.1530/eje-11-0158 ◽

2011 ◽

Vol 165 (1) ◽

pp. 17-24 ◽

Cited By ~ 123

Author(s):

Hermann L Müller ◽

Ursel Gebhardt ◽

Carmen Teske ◽

Andreas Faldum ◽

Isabella Zwiener ◽

...

Keyword(s):

Negative Impact ◽

Prospective Trial ◽

Multivariable Analysis ◽

Multidisciplinary Teams ◽

Hypothalamic Obesity ◽

Surgical Strategies ◽

Hypothalamic Lesions ◽

Patient Load

BackgroundHypothalamic obesity has major impact on prognosis and quality of life (QoL) in childhood craniopharyngioma.Patients and methodsFor this study, 120 patients were prospectively recruited during 2001 and 2007 and evaluated after 3 years of follow-up (KRANIOPHARYNGEOM 2000). Body mass index (BMI) and QoL at diagnosis and 36 months after diagnosis were analysed based on the reference assessment of tumour localisation and post-surgical hypothalamic lesions. Treatment was analysed based on the neurosurgical strategy of 50 participating neurosurgical centres, the centre size based on the patient load.ResultsBMI SDS at diagnosis was similar in patients with or without hypothalamic involvement. Surgical lesions of anterior and posterior hypothalamic areas were associated with higher increase in BMI SDS during 36 months post-diagnosis compared with patients without or only anterior lesion (+1.8 BMISD, P=0.033, +2.1 BMISD; P=0.011), negative impact on QoL in patients with posterior hypothalamic lesions. Surgical strategies varied among the 50 neurosurgical centres (three large-sized, 24 middle-sized and 23 small-sized centres). Patients treated in small-sized centres presented with a higher rate of hypothalamic involvement compared with those treated in the middle- and large-sized centres. Treatment in large-sized centres was less radical, and the rates of complete resection and hypothalamic surgical lesions were lower in large-sized centres than those of the middle- and small-sized centres. However, a multivariable analysis showed that pre-operative hypothalamic involvement was the only independent risk factor for severe obesity (P=0.002).ConclusionsRadical neurosurgical strategies leading to posterior hypothalamic lesions are not recommended due to the potential to exacerbate hypothalamic obesity and impaired QoL. Treatment should be confined to experienced multidisciplinary teams.

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