ArticleJournal of endocrinological investigation2026
History before diagnosis in adult-onset craniopharyngioma: associations with initial presentation and long-term prognosis: a retrospective cohort study of 151 patients.
Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeAdult-onset craniopharyngiomas (CPs) often present after diagnostic delays, yet the prognostic relevance of duration of history (DOH) and specific clinical manifestations remains unexplored.
methodData of patients aged > 18 years at CP diagnosis between June 2012 and October 2024 at the First Affiliated Hospital of Nanchang University were retrospectively reviewed. Associations between DOH, specific symptoms, and tumor characteristics at diagnosis, as well as long-term outcomes, were systematically analyzed.
resultsAmong 151 patients (median follow-up, 71 months) in our cohort, the median DOH was 5 months and showed no significant correlation with tumor volume at diagnosis, hypothalamic involvement, extent of resection, or long-term prognosis including mortality, recurrence, and hypothalamic syndrome at last visit. Patients with amenorrhea/sexual dysfunction in history demonstrated significantly longer DOH (p < 0.001), while those with neurological deficits (p = 0.043) or hydrocephalus (p = 0.044) were associated with shorter DOH. Neurological deficits in history was associated with larger tumor volume at diagnosis (p = 0.016). Headache presented as the first symptom was linked to significantly shorter DOH (p = 0.003) and neurological deficits as the first symptom was associated with worse progression-free survival (p = 0.047).
conclusionDiagnostic delays are common in adult-onset CP patients but appear unrelated to tumor burden or long-term prognosis. Neurological deficits in history or as the first symptom should trigger prompt diagnostic workup and more rigorous follow-up, while prolonged diagnostic delays in those with endocrine symptoms underscore the need for heightened awareness among clinicians to expedite referral and diagnosis.
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