Which primary intracranial tumors cause diabetes insipidus (DI)?

Updated: Mar 18, 2020
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Primary intracranial tumors causing DI include craniopharyngiomas, germinomas, and pineal tumors, among others. The appearance of other hypothalamic manifestations may be delayed for as long as 10 years in these cases.

Craniopharyngioma is a benign tumor that arises from squamous cell nests in the primitive Rathke pouch. It is the most frequent pediatric intracranial neoplasm, accounting for nearly 54% of cases. Central DI insipidus and multiple pituitary hormone deficiencies are common manifestations in childhood craniopharyngiomas. Surgery is the preferred treatment.

A retrospective study by Andereggen et al found that in patients who underwent craniopharyngioma surgery, the presence of postoperative diabetes insipidus was an independent risk factor for hypothalamic obesity (odds ratio 15.2). [8]

A retrospective study by Saldarriaga et al of pediatric patients who underwent transsphenoidal surgery for adrenocorticotropic hormone– or growth hormone–secreting pituitary adenomas found that postoperatively, 26% of the patients developed diabetes insipidus, and 14% developed syndrome of inappropriate antidiuretic hormone secretion (SIADH). Combined risk factors for these postsurgical conditions included female sex, manipulation of the posterior pituitary and/or tumor invasion into the posterior pituitary, and cerebrospinal fluid leak or lumbar drain. [9]


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