Abstract 142: Characteristics and long-term follow-up data of patients with craniopharyngioma; a cross-sectionalstudy at National Hospital of Sri Lanka

Introduction: Craniopharyngioma is a rare tumour with a complex management approach. Available data in the SouthAsian region is limited and knowledge from the locality can improve the approach to patients. Objective: To determine characteristics, management methods and long-term outcomes of patients withcraniopharyngioma followed up at a tertiary care hospital. Method: This cross-sectional study was conducted at the Endocrine Clinic, National Hospital of Sri Lanka fromJanuary 2021 to August 2022. All consenting patients with craniopharyngioma attending the clinic were recruited consecutively. Data were collected via medical records and an interviewer-administered questionnaire. Results: Out of 45 participants, 31 (66.9%) were males. The median age at diagnosis was 21 (Range: 3-66) years whereas the median age at the last follow-up was 37 (Range: 13-75) years. The Median follow-up duration was 8 years. At presentation, headache, vomiting and seizures were recorded in 30 (66.7%), 13 (28.9%), and 5 (11.1%) respectively. Short stature, Diabetes Insipidus, Visual impairment and hydrocephalus wereobserved in 16 (35.6%), 14 (31.1%), 31 (68.9%) and 15 respectively. The mean maximum tumour diameter was 3.17 cm (±2.08). A suprasellar component was seen in 32 (71.1%). Fifteen patients had VP shunt placement before initial tumour resection. All underwent tumour resectionat least once (craniotomy: 35, trans-sphenoidal: ten), whereas nine had two surgeries and three had redosurgery twice. Histology was available in 38 patients and 36 of them were adamantinomatous grade 1 tumours. Residual tumour was observed in 15 (33.3%) after the first surgery and five receivedradiotherapy. Recurrence was observed in fourteen after the residual-free first surgery, and three after radiotherapy. Currently, 25 are tumour free. Panhypopituitarism, diabetes insipidus and visual impairment was observed in 19 (42.2%), 29 (64.4%) and 32 (71.1%) patients following surgery, respectively. Eight patients received growth hormonepostoperatively. Twenty-one (46.7%) experienced weight gain and 5 (11.1%) had behavioural changes. Conclusion: A high recurrence rate even after complete tumour excision suggests the need for careful long-termfollow-up. Post-surgical metabolic, hormonal and structural complications were also observed, indicatingthe requirement for multidisciplinary long-term follow-up and the need to study further on quality of life.