Clinical Characteristics and Outcomes of Pediatric Craniopharyngioma Patients: A Descriptive Study

Objectives: Craniopharyngiomas (CPs) are rare, benign but locally aggressive brain tumors that commonly impair the hypothalamic-pituitary axis, resulting in multiple endocrinopathies, including growth hormone (GH) deficiency. While recombinant human growth hormone (rhGH) therapy is available, data on its long-term benefits, especially in resource-limited settings, are limited. The objective of this study was to describe the clinical characteristics, growth outcomes, and quality of life (QOL) among pediatric CP patients, comparing those treated with rhGH to untreated peers. Material and Methods: A retrospective observational study was conducted at a tertiary hospital in South Africa between 2011 and 2024. Clinical records of 35 patients were reviewed for anthropometric data, endocrine profiles, treatment history, and QOL using the Pediatric Quality of Life Inventory v4.0. short form. Results: GH deficiency was diagnosed in 77% of patients, but only 10 (28.6%) received rhGH therapy. Among treated patients, 30% showed improved growth, while others had suboptimal outcomes due to delayed initiation and non-compliance. Overall QOL scores were poor, with no statistically significant difference between GH-treated and untreated groups. Radical surgical resection was associated with higher QOL scores compared to other interventions. Conclusion: In this cohort, endocrine dysfunction and neurodevelopmental morbidity were prevalent. Although rhGH therapy showed potential growth benefits, its impact was limited by late initiation and poor adherence. Surgical outcomes appeared to have a stronger influence on QOL than GH therapy. Comprehensive, multidisciplinary management remains essential in improving outcomes for pediatric CP patients in low-resource settings.