Craniopharyngioma is a rare benign intracranial tumor that typically arises in the suprasellar region. It accounts for approximately 2–5% of primary brain tumors. The tumor commonly compresses the hypothalamus, optic chiasm, and pituitary gland. Endocrine dysfunction occurs in up to 80–100% of patients at diagnosis or after treatment. Postoperative diabetes insipidus is reported in 40–90% of cases. We report a case of a 32-year-old male with panhypopituitarism and diabetes insipidus secondary to craniopharyngioma who underwent craniotomy and tumor removal. The patient presented with decreased consciousness, dyspnea, polyuria, and fever. He had progressive headaches for six months, accompanied by vomiting, weakness, and blurred vision. Hormonal evaluation showed low cortisol, thyroid-stimulating hormone, free thyroxine, follicle-stimulating hormone, luteinizing hormone, and testosterone levels. Prolactin level remained normal. Clinical manifestations of craniopharyngioma result from mass effect and hypothalamic-pituitary dysfunction. Damage to the pituitary gland may cause multiple hormone deficiencies and dysfunction of target organs. Standard management includes tumor resection followed by lifelong hormone replacement therapy. Surgical treatment may induce or worsen diabetes insipidus due to vasopressin deficiency. This case highlights the complexity of endocrine and perioperative management in craniopharyngioma. Early diagnosis and multidisciplinary care are essential to improve clinical outcomes and quality of life.
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