Craniopharyngioma laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Patients with craniopharyngioma may have abnormal pituitary hormone levels, which is suggestive of disruption of hormone production due to pressure effects on the pituitary gland. The hypothalamic-pituitary axis hormones, namely growth hormone, thyroid hormone, luteinising and follicle stimulating hormone should be measured together with cortisol levels and an assessment of serum and urine osmolality. In addition, an estimate of bone age and, for young females, ovarian ultrasonography is useful. Ideally, any abnormalities should be corrected pre-operatively but, at the very least, low cortisol levels and diabetes insipidus should be treated prior to a surgical procedure.

Laboratory Findings

• The following hormones should be checked in patients who are being suspected of having craniopharyngioma.

1. Serum Growth hormone
2. Serum Leutinizing hormone
3. Serum Follicle stimulating hormone
4. Serum Prolactin
5. Serum Thyroid stimulating hormone
6. Serum ACTH
7. Morning serum cortisol

Metyrapone test

• The rationale for the administration of metyrapone is that it blocks 11-beta-hydroxylase (CYP11B1), the enzyme that catalyzes the conversion of 11-deoxycortisol to cortisol, resulting in a reduction in cortisol secretion.
• The ensuing fall in serum cortisol should, if the hypothalamic-pituitary-adrenal axis is normal, cause an increase in ACTH secretion and therefore an increase in adrenal steroidogenesis up to and including 11-deoxycortisol.

• Besides the hormonal level the following lab test are commonly done in cases of craniopharyngioma.

References

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