Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2006
Lymphocytic hypophysitis with central diabetes insipidus and subsequent hypopituitarism masking a suprasellar germinoma in a 13-year-old girl.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Mikami-Terao Yoko, Akiyama Masaharu, Yanagisawa Takaaki, Takahashi-Fujigasaki Junko, Yokoi Kentaro, Fukuoka Kohei, Sakuma Mio, Miyata Ichiro, Fujisawa Kohji, Oi Shizuo, Eto Yoshikatsu
Аннотация
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.
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.