Bariatric Surgery in a Case of Hypopituitary Patient with Craniopharyngioma: Management of Hypopituitarism and Long-Term Efficacy

Craniopharyngiomas (CP) and their treatment are associated with weight gain often resulting in a syndrome of Hypothalamic Obesity (HO) resistant to dietary and medical interventions. We report a case of successful bariatric surgery in a 21 years old female with panhypopituitarism and HO following CP treatment. Our patient obtained a weight loss (22 kg, -16.8%) at 6 months after Laparoscopic Sleeve Gastrectomy (LSG), a further reduction up to -36% after 11 yr, with weight loss maintained at the last follow-up (12 yr). LSG was associated with severe endocrine complications for a few months; hormonal replacement therapy and nutrient supplementation in the long term were required. Her metabolic profile and quality of life improved. We reviewed data from literature, confirming the efficacy of bariatric surgery in CP patients with similar weight loss after SG and Gastric Bay pass (GB), with serious adverse events only after GB. Hormonal therapeutic adjustments were required.. Bariatric surgery should be considered as a treatment option for morbidly obese CP patients. A multidisciplinary team is necessary to avoid endocrine and systemic complications, not only in the immediate post-operative period but also in the long-term follow-up.