Tzu Chi Medical Journal
Volume 21, Issue 2 , Pages 161-164, June 2009

Short Stature Without Neurological Manifestations in a Child with a Suprasellar Tumor

  • Kun-Shan Cheng

      Affiliations

    • Department of Pediatrics, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
    • ,
  • Nan-Chang Chiu

      Affiliations

    • Department of Pediatrics, Taipei Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Jon-Kway Huang

      Affiliations

    • Department of Radiology, Taipei Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Yann-Jinn Lee

      Affiliations

    • Department of Pediatrics, Taipei Mackay Memorial Hospital, Taipei, Taiwan
    • Department of Medical Research, Taipei Mackay Memorial Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Pediatrics, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei, Taiwan

Received 14 July 2008; received in revised form 14 August 2008; accepted 24 December 2008.

Article Outline

Abstract 

Addressing the problem of short stature in pediatrics is challenging because normal somatic growth depends on a complex interaction between genetic, nutritional, and hormonal factors. We report a 14-year-old girl with deceleration of growth velocity and delayed puberty but no other discernible neurologic or ophthalmologic symptoms or signs. Clonidine and insulin tolerance tests confirmed growth hormone deficiency, and magnetic resonance imaging disclosed a suprasellar mass. This case demonstrates that growth failure may be the only early sign of suprasellar tumor. Rigorous pursuit of the cause of a growth disorder should thus be considered, as it may disclose a potentially serious but treatable condition.

Keywords:  Growth hormone deficiency , Short stature , Suprasellar tumor

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Rappold GA , Fukami M , Niesler B , et al.   Deletions of the homeobox gene SHOX (short stature homeobox) are an important cause of growth failure in children with short stature . J Clin Endocrinol Metab . 2002;87:1402–1406
  2. Vogiatzi MG , Copeland KC . The short child . Pediatr Rev . 1998;19:92–99
  3. Lee JS , Tsai WY , Liu HM , Lin MY , Tu YK . Growth retardation as the initial manifestation of intracranial tumors: report of two cases . Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi . 1994;35:157–162
  4. Hsiao RL , Miau TS , Lu CC , et al.   A survey on weight and height of children (1 month–7 years) and plotting of growth curves (1 month–18 years) in Taiwan, 1987–1988 . Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi . 1990;31:166–175
  5. Luo ZC , Albertsson-Wikland K , Karlberg J . Target height as predicted by parental heights in a population-based study . Pediatr Res . 1998;44:563–571
  6. New MI , Obeid J , Wilson RC , et al.   Profile of the pediatric endocrine clinic at New York-Presbyterian Hospital, New York Weill Cornell Center . J Clin Endocrinol Metab . 1999;84:4444–4449
  7. Voss LD , Mulligan J , Betts PR , Wilkin TJ . Poor growth in school entrants as an index of organic disease: the Wessex growth study . BMJ . 1992;305:1400–1402
  8. Newman CB , Levine LS , New MI . Endocrine function in children with intrasellar and suprasellar neoplasms: before and after therapy . Am J Dis Child . 1981;135:259–266
  9. Aimaretti G , Baffoni C , DiVito L , et al.   Comparisons among old and new provocative tests of GH secretion in 178 normal adults . Eur J Endocrinol . 2000;142:347–352
  10. Parks JS , Felner EI . Hypopituitarism . In:  Kliegman RM ,  Behrman RE ,  Jenson HB ,  Stanton BF editor. Nelson Textbook of Pediatrics . 18th edition. Philadelphia: Elsevier Saunders; 2007;p. 2293–2299
  11. Mahoney CP . Evaluating the child with short stature . Pediatr Clin North Am . 1987;34:825–849
  12. Zargar AH , Laway BA , Masoodi SR , Wani AI , Salahuddin M . An aetiological profile of short stature in the Indian sub-continent . J Paediatr Child Health . 1998;34:571–576
  13. Shin JL , Asa SL , Woodhouse LJ , Smyth HS , Ezzat S . Cystic lesions of the pituitary: clinicopathological features distinguishing craniopharyngioma, Rathke's cleft cyst, and arachnoid cyst . J Clin Endocrinol Metab . 1999;84:3972–3982
  14. Freda PU , Post KD . Differential diagnosis of sellar masses . Endocrinol Metab Clin North Am . 1999;28:81–117
  15. Lafferty AR , Chrousos GP . Pituitary tumors in children and adolescents . J Clin Endocrinol Metab . 1999;84:4317–4323
  16. Karavitaki N , Wass JA . Craniopharyngiomas . Endocrinol Metab Clin North Am . 2008;37:173–193
  17. Weil MD . Stereotactic radiosurgery for brain tumors . Hematol Oncol Clin North Am . 2001;15:1017–1026
  18. Kobayashi T , Kida Y , Mori Y , Hasegawa T . Long-term results of gamma knife surgery for the treatment of craniopharyngioma in 98 consecutive cases . J Neurosurg . 2005;103:482–488
  19. Hayward R . The present and future management of childhood craniopharyngioma . Childs Nerv Syst . 1999;15:764–769
  20. Harsoulis P , Marshall JC , Kuku SF , Burke CW , London DR , Fraser TR . Combined test for assessment of anterior pituitary function . BMJ . 1973;4:326–329

PII: S1016-3190(09)60030-6

doi:10.1016/S1016-3190(09)60030-6

Tzu Chi Medical Journal
Volume 21, Issue 2 , Pages 161-164, June 2009

Article Tools