Infundibuloneurohypophysitis presenting a large sellar-juxtasellar mass: case report.
BACKGROUND
Infundibuloneurohypophysitis (INH) is reported to be a self-limiting inflammatory disease involving neurohypophysis. The authors experienced a case of INH presenting a large mass compressing the brain stem.


METHODS
The patient exhibited polyuria followed by left hemiparesis and dysarthria lasting a year. Magnetic resonance imaging showed a large sellar mass extending into the right cavernous sinus and prepontine cistern and compressing pons. Endocrinologically, diabetes insipidus was diagnosed and anterior pituitary function was almost normal. Microscopic examination of the surgical specimen obtained by a transsphenoidal route demonstrated diffuse infiltration of lymphoid cells with predominance of B cells over T cells and the granulation tissue. The patient underwent 40 Gy local radiation because of initial misinterpretation of histologic findings as malignant lymphoma and short-term corticostertoid administration.


CONCLUSIONS
The mass gradually shrank and the patient has become neurologically intact in 6 months. At this moment, 67 months after the onset, the patient is free from disease and has no other lesion. INH seems to be a clinical entity possessing a wide spectrum from infundibular tumorlet to an aggressive sellar mass trespassing on surrounding structures.
Department of Neurosurgery, Hiroshima University School of Medicine, Hiroshima, Japan.
Yukari
Y
Kanou
Kazunori
K
Arita
Kaoru
K
Kurisu
Atsushi
A
Tominaga
Tomohide
T
Akimitsu
D001706:Biopsy; D001933:Brain Stem / Q000473:pathology; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000473:pathology / Q000601:surgery; D010900:Pituitary Diseases / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D010901:Pituitary Function Tests; D010904:Pituitary Gland, Posterior / Q000473:pathology / Q000601:surgery*; D010910:Pituitary Irradiation