{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:03Z","timestamp":1784557023325,"version":"3.55.0"},"reference-count":18,"publisher":"Bioscientifica","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>This report describes the case of a 37-year-old woman diagnosed with a craniopharyngioma during pregnancy. The patient initially presented with visual impairment at 15 weeks of gestation, and MRI revealed a cystic suprasellar tumor. Endocrine evaluation indicated central hypothyroidism, and central adrenal insufficiency could not be definitively ruled out based on a basal 08:00 h cortisol, as the patient was pregnant and treatment with hydrocortisone was initiated empirically. Hydrocortisone 10 mg\/day and levothyroxine 25 \u00b5g\/day were initiated, but rapid visual deterioration and polyuria by 21 weeks necessitated surgical intervention. She underwent successful treatment with endoscopic transsphenoidal surgery during the second trimester. Adrenal function was assessed on postoperative day 7 based on baseline values, but hydrocortisone was maintained given the risk during pregnancy. At 6 weeks after surgery, pituitary hormones were reassessed, and hydrocortisone, levothyroxine, and desmopressin were continued. Arginine vasopressin deficiency was diagnosed based on polyuria, hypotonic urine, and response to desmopressin, as formal testing was high risk both before and after surgery. Postoperatively, endocrine status was monitored, and pregnancy progressed uneventfully. She underwent an elective cesarean section at 38 weeks of gestation. At 6 months postpartum, MRI revealed residual tumor along the pituitary stalk extending from the right optic chiasm. At 9 months postpartum, the patient had persistent central hypothyroidism, hypogonadism, and newly diagnosed adult GH deficiency. Normal adrenal function allowed discontinuation of hydrocortisone. GH therapy was planned pending tumor assessment. This case underscores the importance of a multidisciplinary approach involving obstetrics, neurosurgery, and endocrinology in managing craniopharyngiomas during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Regardless of pregnancy planning, central hypogonadism should always be investigated with a brain MRI to determine its etiology, including the potential presence of a craniopharyngioma or other sellar\/parasellar lesions.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>If a craniopharyngioma enlarges during pregnancy and causes visual impairment, surgical intervention can be performed through multidisciplinary collaboration.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The mode of delivery in patients with panhypopituitarism should be carefully determined through multidisciplinary consultation between obstetricians and endocrinologists, with consideration of planned cesarean section as a potential option.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-25-0028","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T16:16:27Z","timestamp":1752164187000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["High-risk pregnancy complicated by craniopharyngioma: diagnosis in the context of visual impairment and tumor resection during pregnancy following IVF"],"prefix":"10.1530","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3571-0200","authenticated-orcid":true,"given":"Yuki","family":"Tsujimoto","sequence":"first","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yamashiro","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Okubo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Samura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudo","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rimei","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"J Neurosurg","first-page":"547","article-title":"The descriptive epidemiology of craniopharyngioma","volume":"89","author":"Bunin GR","year":"1998","unstructured":"Bunin GR\n, \nSurawicz TS\n, \nWitman PA\n, et al.\n The descriptive epidemiology of craniopharyngioma. J Neurosurg 1998 89 547\u2013551. (https:\/\/doi.org\/10.3171\/jns.1998.89.4.0547)"},{"key":"bib2","series-title":"Radiol Oncol","first-page":"388","article-title":"Advances in the management of craniopharyngioma in children and adults","volume":"53","author":"Jensterle M","year":"2019","unstructured":"Jensterle M\n, \nJazbinsek S\n, \nBosnjak R\n, et al.\n Advances in the management of craniopharyngioma in children and adults. Radiol Oncol 2019 53 388\u2013396. (https:\/\/doi.org\/10.2478\/raon-2019-0036)"},{"key":"bib3","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"269","article-title":"Diabetes insipidus in pregnancy as a first sign of a craniopharyngioma","volume":"10","author":"van der Wildt B","year":"1980","unstructured":"van der Wildt B\n, \nDrayer JI\n & \nEskes TK\n\n. Diabetes insipidus in pregnancy as a first sign of a craniopharyngioma. Eur J Obstet Gynecol Reprod Biol 1980 10 269\u2013274. (https:\/\/doi.org\/10.1016\/0028-2243(80)90007-6)"},{"key":"bib4","series-title":"Obstet Gynecol","first-page":"982","article-title":"Diabetes insipidus associated with craniopharyngioma in pregnancy","volume":"76","author":"Hiett AK","year":"1990","unstructured":"Hiett AK\n & \nBarton JR\n\n. Diabetes insipidus associated with craniopharyngioma in pregnancy. Obstet Gynecol 1990 76 982\u2013984. (https:\/\/doi.org\/10.1097\/00006250-199011000-00069)"},{"key":"bib5","series-title":"Case Rep Neurol Med","article-title":"Haemorrhagic presentation of a craniopharyngioma in a pregnant woman","volume":"2014","author":"Zoia C","year":"2014","unstructured":"Zoia C\n, \nCattalani A\n, \nTurpini E\n, et al.\n Haemorrhagic presentation of a craniopharyngioma in a pregnant woman. Case Rep Neurol Med 2014 2014 435208. (https:\/\/doi.org\/10.1155\/2014\/435208)"},{"key":"bib6","series-title":"Surg Neurol","first-page":"257","article-title":"Fertility following excision of a symptomatic craniopharyngioma during pregnancy: case report","volume":"39","author":"Johnson RJ Jr","year":"1993","unstructured":"Johnson RJ Jr\n, \nVoorhies RM\n, \nWitkin M\n, et al.\n Fertility following excision of a symptomatic craniopharyngioma during pregnancy: case report. Surg Neurol 1993 39 257\u2013262. (https:\/\/doi.org\/10.1016\/0090-3019(93)90001-h)"},{"key":"bib7","series-title":"Br J Obstet Gynaecol","first-page":"577","article-title":"Rapid enlargement of carniopharyngioma in pregnancy","volume":"85","author":"Sachs BP","year":"1978","unstructured":"Sachs BP\n, \nSmith SK\n, \nCassar J\n, et al.\n Rapid enlargement of carniopharyngioma in pregnancy. Br J Obstet Gynaecol 1978 85 577\u2013578."},{"key":"bib8","series-title":"Surg Neurol","first-page":"324","article-title":"Rapid recurrence of craniopharyngioma during pregnancy with recovery of vision: a case report","volume":"45","author":"Maniker AH","year":"1996","unstructured":"Maniker AH\n & \nKrieger AJ\n\n. Rapid recurrence of craniopharyngioma during pregnancy with recovery of vision: a case report. Surg Neurol 1996 45 324\u2013327. (https:\/\/doi.org\/10.1016\/0090-3019(95)00399-1)"},{"key":"bib9","series-title":"J Neurosurg","first-page":"322","article-title":"Rapid enlargement and recurrence of a preexisting intrasellar craniopharyngioma during the course of two pregnancies. Case report","volume":"91","author":"Aydin Y","year":"1999","unstructured":"Aydin Y\n, \nCan SM\n, \nG\u016dlkilik A\n, et al.\n Rapid enlargement and recurrence of a preexisting intrasellar craniopharyngioma during the course of two pregnancies. Case report. J Neurosurg 1999 91 322\u2013324. (https:\/\/doi.org\/10.3171\/jns.1999.91.2.0322)"},{"key":"bib10","series-title":"Cureus","article-title":"A rare occurrence of craniopharyngioma causing visual disturbance in pregnancy","volume":"13","author":"Wai Wye NH","year":"2021","unstructured":"Wai Wye NH\n, \nNaffi AA\n, \nOthman O\n, et al.\n A rare occurrence of craniopharyngioma causing visual disturbance in pregnancy. Cureus 2021 13 e18700. (https:\/\/doi.org\/10.7759\/cureus.18700)"},{"key":"bib11","series-title":"Front Oncol","article-title":"Case report: a pregnant woman with recurrent craniopharyngioma: surgical decision-making and doctor-patient bond","volume":"14","author":"Shen A","year":"2024","unstructured":"Shen A\n, \nMin Y\n, \nHe S\n, et al.\n Case report: a pregnant woman with recurrent craniopharyngioma: surgical decision-making and doctor-patient bond. Front Oncol 2024 14 1508803. (https:\/\/doi.org\/10.3389\/fonc.2024.1508803)"},{"key":"bib12","series-title":"Neurosurgery","first-page":"1014","article-title":"Craniopharyngioma presenting during pregnancy 4 years after a normal magnetic resonance imaging scan: case report","volume":"49","author":"Magge SN","year":"2001","unstructured":"Magge SN\n, \nBrunt M\n & \nScott RM\n\n. Craniopharyngioma presenting during pregnancy 4 years after a normal magnetic resonance imaging scan: case report. Neurosurgery 2001 49 1014\u20131016. (https:\/\/doi.org\/10.1227\/00006123-200110000-00045)"},{"key":"bib13","series-title":"Am J Obstet Gynecol","first-page":"1095","article-title":"Plasma estrone, estradiol, estriol, progesterone, and 17-hydroxyprogesterone in human pregnancy. I. Normal pregnancy","volume":"112","author":"Tulchinsky D","year":"1972","unstructured":"Tulchinsky D\n, \nHobel CJ\n, \nYeager E\n, et al.\n Plasma estrone, estradiol, estriol, progesterone, and 17-hydroxyprogesterone in human pregnancy. I. Normal pregnancy. Am J Obstet Gynecol 1972 112 1095\u20131100. (https:\/\/doi.org\/10.1016\/0002-9378(72)90185-8)"},{"key":"bib14","series-title":"Neurosurgery","first-page":"1012","article-title":"Estrogen receptor gene expression in craniopharyngiomas: an in situ hybridization study","volume":"35","author":"Thapar K","year":"1994","unstructured":"Thapar K\n, \nStefaneanu L\n, \nKovacs K\n, et al.\n Estrogen receptor gene expression in craniopharyngiomas: an in situ hybridization study. Neurosurgery 1994 35 1012\u20131017. (https:\/\/doi.org\/10.1097\/00006123-199412000-00002)"},{"key":"bib15","series-title":"J Pediatr Neurosci","first-page":"113","article-title":"Volume increase in craniopharyngiomas under growth hormone and\/or sex hormones substitution: role of tumors receptors or mere coincidence?","volume":"8","author":"Chentli F","year":"2013","unstructured":"Chentli F\n, \nDeghima S\n, \nZellagui H\n, et al.\n Volume increase in craniopharyngiomas under growth hormone and\/or sex hormones substitution: role of tumors receptors or mere coincidence? J Pediatr Neurosci 2013 8 113\u2013116. (https:\/\/doi.org\/10.4103\/1817-1745.117839)"},{"key":"bib16","series-title":"J Clin Med Res","first-page":"281","article-title":"Sex hormone receptor expression in craniopharyngiomas and association with tumor aggressiveness characteristics","volume":"11","author":"Mart\u00ednez-Ortega A","year":"2022","unstructured":"Mart\u00ednez-Ortega A\n, \nFlores-Martinez \u00c1\n, \nVenegas-Moreno E\n, et al.\n Sex hormone receptor expression in craniopharyngiomas and association with tumor aggressiveness characteristics. J Clin Med Res 2022 11 281. (https:\/\/doi.org\/10.3390\/jcm11010281)"},{"key":"bib17","series-title":"Obstetrical Gynecol Surv","first-page":"450","article-title":"DDAVP use during pregnancy: an analysis of its safety for mother and child","volume":"53","author":"Ray JG","year":"1998","unstructured":"Ray JG\n\n. DDAVP use during pregnancy: an analysis of its safety for mother and child. Obstetrical Gynecol Surv 1998 53 450\u2013455. (https:\/\/doi.org\/10.1097\/00006254-199807000-00025)"},{"key":"bib18","series-title":"Nat Rev Endocrinol","first-page":"610","article-title":"Thyroid disease in pregnancy: new insights in diagnosis and clinical management","volume":"13","author":"Korevaar TIM","year":"2017","unstructured":"Korevaar TIM\n, \nMedici M\n, \nVisser TJ\n, et al.\n Thyroid disease in pregnancy: new insights in diagnosis and clinical management. Nat Rev Endocrinol 2017 13 610\u2013622. (https:\/\/doi.org\/10.1038\/nrendo.2017.93)"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2025\/3\/EDM-25-0028.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2025\/3\/EDM-25-0028.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2025\/3\/EDM-25-0028.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:36Z","timestamp":1784555316000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3822"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":18,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1530\/edm-25-0028","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}