ID #613 Long Term Morbidity of Pediatric Suprasellar Tumors: A Single Tertiary Centre Experience

Introduction

Suprasellar brain tumors in children are associated with significant long-term morbidity. We aim to evaluate the prevalence of these complications for optimising long-term survivorship care.

Methods

Patients were identified from the pediatric hematology and oncology unit’s registry between year 2000 to 2023. Clinical data were collected retrospectively and updated clinical outcomes were obtained.

Results

A total of 152 pediatric patients was diagnosed with brain tumors and suprasellar tumors accounted for 11% (n = 16) of cases. Median age at diagnosis was 8-year-old and male to female ratio was 3:2. The most common suprasellar tumors was germ cell tumor (50%, n = 8), followed by low grade glioma (31%, n = 5). One patient each had meningioma and craniopharyngioma, and one had unknown histopathology due to inadequate tissue. Majority (69%, n = 11) had histopathological examinations, while four patients with germ cell tumor were diagnosed via raised tumor markers.

Eleven (69%) patients continued in long-term follow-up with a median follow-up of 15 years and median age of 18-year-old. Five (31%) patients were deceased at the time of analysis. All survivors experienced persistent morbidity. Endocrine dysfunction was the most common complication, with 82% (n = 9) having two or more endocrinopathies requiring lifelong hormone replacement therapy. Visual impairment occurred in 64% (n = 7) with four patients experiencing unilateral or bilateral blindness affecting daily function. Hypothalamic dysfunction with excessive weight gain was observed in 64% (n = 7), two of whom also had sleep disturbance. Residual neurological deficits were present in 18% (n = 2), and one patient required long-term anti-epileptic medication.

Six (55%) survivors were still in school, equally divided between special education and mainstream schools. Among adult survivors, only two (40.0%) were employed.

Conclusion

Children treated for suprasellar brain tumors at our center experienced significant long-term morbidity, emphasizing the need for structured, multidisciplinary holistic approach to improve quality of life.