title: [Pituitary germinoma presenting as a pseudotumoral lymphocytic hypophysitis in a man].
abstract: A 45-year-old man presented with headaches and extraocular muscle palsy due to a sellar mass extending into the right cavernous sinus. Hormonal determinations revealed a gonadotrophic insufficiency. A transsphenoidal surgical removal revealed a lymphocytic hypophysitis with fibrosis and necrosis. Rapid growth of the pseudotumor was noted despite a high dose steroid therapy (1 mg/kg/d) for a month. Further biological and histopathological investigations were performed. They showed a high cerebrospinal fluid (CSF) B-human chorionic gonadotropin (ss-HCG) level of 12 UI/L (normal<5 UI/L), normal plasma BHCG level, and undetectable CSF and plasma alpha-fetoprotein levels. The tumors cells showed a positive reactivity for placental alkaline phosphatase and for vimentin. These findings were consistent with an inflammatory lymphocytic process caused by an intrasellar germinoma. Chemotherapy was ill-tolerated and external radiotherapy was ineffective.
authors.affiliation: Services de Médecine Interne, Endocrinologie et Maladies Métaboliques, France.
authors.forename: F
authors.initials: F
authors.lastname: Torremocha
authors.forename: S
authors.initials: S
authors.lastname: Hadjadj
authors.forename: E
authors.initials: E
authors.lastname: Menet
authors.forename: A
authors.initials: A
authors.lastname: Kas
authors.forename: H
authors.initials: H
authors.lastname: Bourgeois
authors.forename: P
authors.initials: P
authors.lastname: Levillain
authors.forename: B
authors.initials: B
authors.lastname: Bataille
authors.forename: R
authors.initials: R
authors.lastname: Maréchaud
mesh_terms: D000469:Alkaline Phosphatase / Q000032:analysis; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D005355:Fibrosis; D018237:Germinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014746:Vimentin / Q000032:analysis; D000509:alpha-Fetoproteins / Q000032:analysis / Q000134:cerebrospinal fluid
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D014746:Vimentin; D000509:alpha-Fetoproteins; D000469:Alkaline Phosphatase
vernacular_title: Germinome hypophysaire révélé par une hypophysite lymphocytaire pseudo-tumorale chez un homme.