Craneopharyngioma as a cause of central obesity: Case report and literature review

Abstract

Obesity of central or hypothalamic origin is a possible complication due to craniopharyngioma or its treatment. Craniopharyngiomas are benign tumors that, despite being rare, represent 80% of neoplasms in the hypothalamic-pituitary region, and can affect the quality of life of patients due to various and frequent sequelae, including central obesity. The hypothalamic nuclei responsible for appetite and basal metabolism of the organism are involved in the pathophysiological mechanism of this disorder. We present the case of a 15-year-old patient, with a body mass index of 48 kg/m2 and type 2 diabetes mellitus undergoing treatment, who was referred to our hospital due to acute nausea and vomiting, as well as presence of various neurological symptoms. Physical examination revealed significant generalized obesity, a short neck, marked cervical acanthosis and flexion folds, mild bimalleolar edema, 8 cm cryptopenis, and asymmetrical Tanner IV testicles. Subsequently, the diagnosis of craniopharyngioma is established after considering the patient's personal history, clinical findings, and laboratory and imaging studies requested. Thanks to the opportune surgical intervention, important clinical and laboratory improvement was prepared in the control appointments, leaving central obesity as a sequel. Comprehensive management of complications from craniopharyngioma significantly optimizes the quality of life of people with this type of sellar tumor.