Obesity and craniopharyngioma

As results of advances in treatment, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. In the United States, there are approximately 270.000 survivors of pediatric cancer reaching the amount of about 1 every 640 adults between the ages of 20 and 39 years [1]. The improved survival rates have resulted in increased attention on late side-effects. They can include second malignancies, cardiovascular abnormalities, pulmonary complications, endocrine consequences and obesity. In the Childhood Cancer Survivor Study, the survivor population is considered a high-risk population. Thirty years after a diagnosis of cancer, almost three fourths of survivors have a chronic health condition, more than 40% have a serious health problem and one third have multiple conditions [2]. Some of these adverse health effects may be modifiable and, therefore, the long-term monitoring of survivors has became an important part of their overall health care and the identification of treatment and patient factors that contribute to them is now crucial.Obesity is a well-recognized complication of tumors localized in the hypothalamic-pituitary region. In childhood, craniopharyngioma is the most common neoplasm of the hypothalamic-pituitary area, accounting for approximately 80% of tumors in this location and represents 5-15% of intracranial tumors [3]. A Childhood Cancer Registry estimates an incidence of craniopharyngioma of 1.4 cases per million children per year in Italy [4]. Similar data are provided by other registries in Western countries, while higher rates have been observed in Asia and Africa. Craniopharyngioma has a bimodal age distribution with a peak between 5 and 14 years of age, and a second one in adults older than 65 years. Even if it is not truly malignant, it is locally invasive and grows slowly in the suprasellar region. During its growth, craniopharyngioma could invade surrounding tissue including the hypothalamus and optic chia