Hypopituitarism following a direct bullet injury to the pituitary. A case report.
A 29-year old man was referred for hypogonadism. At 14 years of age he was struck by a gun bullet in the head, receiving a frontomedial open fracture with leakage of cerebral tissue. The bullet could not be extracted at the operation. At 16 years of age he noticed a stop of pubertal development, weight gain and a fall in visus on the left eye. The clinical examination and the endocrinological data (low F-T4 and F-T3; low plasma cortisol and testosterone; normal plasma prolactin; sub-normal pituitary response to intravenous administration of insulin, GnRH, TRH and GRF) demonstrated that the patient was hypopituitaric. A radiological skull X-ray showed that the bullet was lodged in the sellar and parasellar region. This seems to be the seventh case of hypopituitarism following a direct injury to the pituitary region described in the literature so far.
Lo Iudice
G
G
D'Alessandro
B
B
Esposito
V
V
Federico
P
P
Mignini
R
R
Rispoli
C
C
D000328:Adult; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D008297:Male; D010902:Pituitary Gland / Q000293:injuries*; D014948:Wounds, Gunshot / Q000150:complications*