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Pituitary

, Volume 18, Issue 5, pp 642–657 | Cite as

The infundibulo-tuberal syndrome caused by craniopharyngiomas: clinicopathological evidence from an historical French cohort (1705–1973)

  • Inés Castro-Dufourny
  • Rodrigo Carrasco
  • Ruth Prieto
  • Laura Barrios
  • José M. Pascual
Article

Abstract

Purpose

Infundibulo-tuberal syndrome groups endocrine, metabolic and behavioral disturbances caused by lesions involving the upper neurohypophysis (median eminence) and adjacent basal hypothalamus (tuber cinereum). It was originally described by Henri Claude and Jean Lhermitte in 1917, in a patient with a craniopharyngioma. This study investigates the clinical, pathological and surgical evidence verifying the infundibulo-tuberal syndrome caused by craniopharyngiomas (CPs).

Methods

A systematic retrospective review of craniopharyngiomas reported in French literature between 1705 and 1973 was conducted. A total of 128 well described reports providing a comprehensive clinical and pathological description of the tumors were selected. This series represents the historical French cohort of CPs reported in the pre-CT/MRI era.

Results

Three major syndromes caused by CPs were categorized: pituitary syndrome (35 %), infundibulo-tuberal syndrome (52 %) and hypothalamic syndrome (49 %). CP topography was significantly related to the type of syndrome described (p < 0.001). Infundibulo-tuberal syndrome occurred in CPs which replaced or invaded the third ventricle floor. In contrast, the majority of sellar/suprasellar CPs growing below the third ventricle showed a pituitary syndrome (82 %). Cases with hypothalamic syndrome were characterized by anatomical integrity of the pituitary gland and stalk (p = 0.033) and occurred predominantly in adults older than 41 years old (p < 0.005). Among infundibulo-tuberal symptoms, abnormal somnolence was not related with the presence of hydrocephalus. All squamous-papillary CPs presented psychiatric disturbances (p < 0.001).

Conclusion

This historical CP cohort evidences a clinical-topographical correlation between the patient’s type of syndrome and the anatomical structures involved by the tumor along the hypophysial-hypothalamic axis.

Keywords

Craniopharyngioma Fröhlich syndrome Hypothalamus Infundibulo-tuberal Pituitary gland Third ventricle 

Abbreviations

CPs

Craniopharyngiomas

CT

Computed tomography

DI

Diabetes insipidus

IT

Infundibulo-tuberal

MRI

Magnetic resonance imaging

TVF

Third ventricle floor

3V

Third ventricle

Notes

Acknowledgments

The authors wish to especially thank Crystal Smith, Reference Librarian of the Department of History of Medicine at the National Library of Medicine, National Institutes of Health, Bethesda, Maryland, and Lucretia MacLure and all the staff at the Francis Countway Medical Library at Harvard Medical School, Boston, Massachusetts, for their invaluable help in obtaining some of the original research material used for this study. Finally, the authors wish to express their gratitude to George Hamilton for his critical review of the language and style of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Inés Castro-Dufourny
    • 1
  • Rodrigo Carrasco
    • 2
  • Ruth Prieto
    • 3
  • Laura Barrios
    • 4
  • José M. Pascual
    • 5
  1. 1.Department of EndocrinologySureste University HospitalMadridSpain
  2. 2.Department of NeurosurgeryRamón y Cajal University HospitalMadridSpain
  3. 3.Department of NeurosurgeryPuerta de Hierro University HospitalMadridSpain
  4. 4.Statistics Department, Computing CenterCSICMadridSpain
  5. 5.Department of NeurosurgeryLa Princesa University HospitalMadridSpain

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