Beyond the tumor - endocrine and metabolic dysregulation in intracranial germ cell tumors - a retrospective cohort study

Sep 29, 2026

Intracranial germ cell tumors often cause endocrine-metabolic complications, yet their long-term pattern is insufficiently characterized. This retrospective cohort study evaluates endocrine and metabolic dysfunction before and after iGCT treatment in 99 patients. Results show pronounced post-treatment hormonal and metabolic disturbances, including frequent hormone replacement, growth hormone deficiency, dyslipidemia, and increased overweight/obesity, alongside shifts in specific endocrine parameters. Radiotherapy-related late effects support ongoing monitoring and early intervention to protect long-term quality of life.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

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Abstract

Introduction

Methods

Study population

Results

Conclusion

Article published online: 2025-10-27 Original Article 1 Beyond the tumor: endocrine and metabolic dysregulation in intracranial germ cell tumors – a retrospective cohort study Mayco José Reinaldi Serra 1,2,3 Angela Maria Spinola-Castro 1,3 Nasjla Saba da Silva3 Andrea Cappellano3 Paola Matiko Martins Okuda 1 Adriana Aparecida Siviero-Miachon 1,3 1 Universidade Federal de São Paulo, São Paulo SP, Brazil. Address for correspondence Angela Maria Spinola e Castro 2 Universidade Lusiada, Santos SP, Brazil. (email: [angela. spinola@unifesp.br](angela. spinola@unifesp.br)) 3 Grupo de Apoio ao Adolescente e à Criança com Câncer, São Paulo SP, Brazil. Arq. Neuro-Psiquiatr. 2025;83(10):s00451812300 . Abstract Keywords ► Germinoma ► Central Nervous System Diseases ► Hypopituitarism ► Obesity ► Diabetes Insipidus ► Radiotherapy Background Intracranial germ cell tumors (iGCTs) often lead to endocrine-metabolic complications;however, their long-term effects are not well understood and characterized. Objective To evaluate endocrine-metabolic dysfunction before and after iGCTs treatment. Methods The present retrospective study included 99 patients with iGCTs treated at a tertiary hospital. Endocrine and metabolic parameters were assessed before and after treatment. Results A male sex predominance was observed (81.8%) . The leading site was pineal (44.4%), and 67.7% of the tumors were classiﬁed as germinoma. Radiotherapy was performed in 82.8% of the cases (58.5% cranial and 41.5% craniospinal) . At diagnosis, the incidences of gonadotropin-independent precocious puberty and diabetes insipidus were 15.2% and 48.2%, respectively. Signiﬁcant endocrine-metabolic changes in patients with iGCTs were observed after treatment, as 72.3% of patients required hormone replacement, 60% had growth hormone deﬁciency, and dyslipidemia was observed in 49.2% of patients. Overweight increased from 24.2 to 35.4% after treatment, while obesity increased from 10.1 to 15.4% . There was an increase in growth hormone deﬁciency, hypothyroidism, and hypogonadism, while prolactin levels signiﬁcantly decreased after treatment. An older age at diagnosis was associated with a lower risk of hypocortisolism (p ¼ 0.005) . Regarding sex, females had lower height Z-scores and a higher frequency of growth hormone deﬁciency comparedwith males. Tumor-related mortality was reported in 22.2% of patients, occurring on average 2.2 years postdiagnosis. Conclusion The high prevalence of endocrine-metabolic complications following radiotherapy highlights the necessity of ongoing monitoring. The treatment demonstrated signiﬁcant efﬁcacy, as reﬂected by the notable survival rates. Early intervention is crucial for improving the long-term quality of life. received April 23, 2025 received in its ﬁnal form July 20, 2025 accepted August 2, 2025 DOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1812300 . ISSN 0004-282X. Editor-in-Chief: Hélio A. G. Teive. Associate Editor: Suzana Maria Fleury Malheiros. © 2025 . The Author(s) . This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)) Thieme Revinter Publicações Ltda. , Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil 2 Endocrine dysfunction of germ cell tumor Serra et al. INTRODUCTION Intracranial germ cell tumors (iGCTs) primarily affect children and young adults, accounting for 􀀂 3.3% of cases in children aged 0 to 14 years.1 The observed incidence is 5 .5% in children with central nervous system (CNS) neoplasms undergoing radiotherapy (RT) and up to 14% in cases of CNS neoplasms in Asian countries.2,3 Germinomas are the most prevalent iGCTs in the pineal and sellar

FAQs

What was the main objective of the study?

To evaluate endocrine-metabolic dysfunction before and after treatment of intracranial germ cell tumors.

How many patients were included, and what type of study was it?

The study was retrospective and included 99 patients treated at a tertiary hospital.

Which endocrine-metabolic changes were most notable after treatment?

Most patients required hormone replacement, growth hormone deficiency was common, dyslipidemia occurred in about half, and overweight and obesity increased after treatment.

Sep 29, 2026

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