Introduction: Primary intracranial tumor is the second most common cause of childhood malignancy, and the most common cause of acquired hypopituitarism. This study determined the prevalence of the endocrine manifestations among children with primary intracranial tumors, and identified associated clinical and tumor-related factors.Method: Data was extracted from medical records of patients aged less than 19 years diagnosed with primary intracranial tumor admitted in Philippine Children’s Medical Center (PCMC), a single- specialty hospital for children. Clinical characteristics of patients including age, sex, type of tumor, and treatment modalities applied were collected by reviewing patients’ charts. Tumor-related features were taken from official cranial imaging results. Endocrine manifestations were derived from available clinical and biochemical data.Results and Discussion: Medical records of one hundred fifty-five (155) children were included in the analysis. 75 (48.4%) were male, and 80 (51.6%) were female. 90 (58.1%) were aged above 2 years old. The most common primary intracranial tumor in this study was non-germinomatous germ cell tumor (NGGCT) (n=54; 34.8%); other tumor types were astrocytoma (n= 38; 24.5%), craniopharyngioma (n=23; 14.5%) and ependymoma (n= 18; 11.6%). The majority received one or more treatment modalities. One hundred sixteen patients underwent neurosurgery (74.8%), 42 (27.1%) had chemotherapy, and 14 (9.0%) received radiotherapy.Fifty-five patients (35.5%) had one or more endocrine disorders. Seventy-one endocrine manifestations were identified, and short stature was the most common (n=35, 63.6 %). Other endocrine disorders identified were hypothyroidism (n=8, 14.5%), hypocortisolism (n=8, 14.5%), cerebral salt wasting (n=8, 14.5%), syndrome of inappropriate antidiuretic hormone secretion (n=7, 12.7%), and central diabetes insipidus (n=5, 9.1%).Clinical factors significantly associated with endocrine manifestations included age > 2 years (p=0.0009), female gender (p= 0.0009), and duration of illness < 2 months (p = 0.0021). NGGCT and craniopharyngioma were the most common tumor types associated with endocrine manifestations. Tumor-related factors significantly associated with endocrine disorders included tumor size of ≥3 cm (p=<0.001), presence of hydrocephalus (p=0.0003), and complex features (p=0.0011) on cranial imaging.Short stature was present before treatment intervention, and additional hormone deficiencies were identified after neurosurgery, chemotherapy or radiotherapy. CSW, SIADH and central DI were more common after receiving neurosurgery and chemotherapy. Hypothyroidism and hypocortisolism were more common after neurosurgery. Hypothyroidism (n=4, 50%) was significantly associated with radiotherapy (p=0.0440); it is the only additional endocrine deficiency documented after the procedure.Conclusion: This study demonstrates that endocrine manifestations are prevalent in children with primary intracranial tumors upon diagnosis and after treatment intervention. Identification of clinical and tumor-related risk factors provides an opportunity for early recognition and management of endocrine disorders in children.
