title: Diencephalic syndrome of emaciation in an adult associated with a third ventricle intrinsic craniopharyngioma: case report.
abstract: OBJECTIVE
  Diencephalic syndrome of emaciation (DS) is seen almost exclusively in infants and young children, and only two cases of DS in adults have been reported previously. We describe a case of DS associated with a third ventricle intrinsic craniopharyngioma in an adult patient.
  
  
  METHODS
  A 54-year-old man presented with profound emaciation, disorientation, memory loss, and psychological disorders. Computed tomographic scanning and magnetic resonance imaging of his brain disclosed a tumor within the third ventricle. The preoperative endocrinological examination indicated an elevated growth hormone level and a decreased somatomedin C level.
  
  
  METHODS
  The patient underwent partial resection of the tumor, which was adherent to the floor of the third ventricle but not to the ventricle wall, by an interhemispheric-transcallosal approach. The histological examination revealed a squamous papillary-type craniopharyngioma. The patient received 50 Gy of radiotherapy, which resulted in 90 to 95% reduction of the tumor size within 6 months, as indicated by the magnetic resonance images presented. The psychological disorders, memory disturbance, and severe emaciation improved gradually thereafter.
  
  
  CONCLUSIONS
  Although extremely rare, DS can occur in an adult harboring a tumor in the anterior hypothalamus.
authors.affiliation: Department of Neurological Surgery, Sumitomo Besshi Hospital, Niihama, Japan. ya-miyo@dokkyomed.ac.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yunoki
authors.forename: Akimasa
authors.initials: A
authors.lastname: Yano
authors.forename: Ken
authors.initials: K
authors.lastname: Nishimoto
mesh_terms: D002551:Cerebral Ventricle Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D003937:Diagnosis, Differential; D004614:Emaciation / Q000209:etiology*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007027:Hypothalamic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I