Erschienen in:
01.10.2006 | Case Report
Lymphocytic hypophysitis with central diabetes insipidus and subsequent hypopituitarism masking a suprasellar germinoma in a 13-year-old girl
verfasst von:
Yoko Mikami-Terao, Masaharu Akiyama, Takaaki Yanagisawa, Junko Takahashi-Fujigasaki, Kentaro Yokoi, Kohei Fukuoka, Mio Sakuma, Ichiro Miyata, Kohji Fujisawa, Shizuo Oi, Yoshikatsu Eto
Erschienen in:
Child's Nervous System
|
Ausgabe 10/2006
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Abstract
Case report
We report a case of central diabetes insipidus, hypothyroidism, and subsequent hypopituitarism due to lymphocytic hypophysitis masking a germinoma in a 13-year-old pubertal girl. Magnetic resonance revealed an enlarged pituitary gland and a mass lesion in the pituitary stalk and inferior hypothalamus. Open cranial surgery of the anterior pituitary showed active hypophysitis with lymphocytic infiltrates but without necrosis. Despite prednisolone therapy, 1 year later an enlarged, irregular cystic mass lesion had developed; in the pituitary stalk and inferior hypothalamus, a endoscopic biopsy revealed germinoma.
Conclusion
Lymphocytic hypophysitis in children may be the first sign of a host reaction to an occult germinoma. The diagnosis of central diabetes insipidus with a thickened pituitary stalk requires long-term follow-up to establish the underlying cause.