Gamma knife surgery for lymphocytic hypophysitis.
Lymphocytic hypophysitis is a relatively uncommon autoimmune inflammatory disorder affecting the pituitary gland. It most frequently occurs in women of child-bearing age. The authors report on their experience with a patient who presented with diplopia and marked enlargement of the pituitary gland. She underwent transsphenoidal surgery, and histopathological analysis confirmed the diagnosis of lymphocytic hypophysitis. The disease proved refractory to resection, and any attempt at withdrawal of corticosteroid therapy resulted in a return of the patient's symptoms and enlargement of the sellar contents. The patient underwent Gamma Knife surgery (GKS) to the sella and both cavernous sinuses. After GKS, the patient was able to discontinue steroid therapy without return of her symptoms. Follow-up MR images demonstrated no evidence of recurrence of lymphocytic hypophysitis. For persistent lymphocytic hypophysitis, GKS is a reasonable treatment option.
Ray
Dibyendu Kumar
DK
Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
Yen
Chun Po
CP
Vance
Mary Lee
ML
Laws
Edward R
ER
Lopes
Beatriz
B
Sheehan
Jason P
JP
D000328:Adult; D020274:Autoimmune Diseases of the Nervous System / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery; D004172:Diplopia / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology / Q000601:surgery*; D016634:Radiosurgery; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome