[Lymphoma of the pituitary stalk].
BACKGROUND
Tumors of the pituitary stalk are rare and their diagnosis is sometimes difficult.


METHODS
We report a case of a primary lymphoma of the pituitary stalk in a 78-year-old patient. To our knowledge, only seven similar cases have been previously published: prominent symptoms were headache, fatigue and diplopia; biologically, anterior pituitary low secretion or hyperprolactinemia were found in the majority of cases; regarding the imaging, only three patients presented an initial and isolated lesion of the stalk; histological evidence was obtained by a trans-sphenoidal biopsy in case of hypothalamic or pituitary associated lesion or by a trans-cranial biopsy in the event of an isolated lesion. As an alternative, a lumbar puncture could be performed; although less invasive, its diagnostic performance is lower.


CONCLUSIONS
Current treatment relies on chemotherapy with intravenous methotrexate associated with intrathecal methotrexate infusion if cerebrospinal showed abnormal cells. Unfortunately, the results remain poor with a median survival of 9 months.
Krypciak
S
S
Département de médecine interne et de gériatrie, CHU Chenevier-Mondor, 51, avenue du Maréchal-de-Tassigny, 94000 Créteil, France.
Alonso
E
E
Berle
M
M
Ajzenberg
C
C
Combes
C
C
Caillet
P
P
Taillandier-Heriche
E
E
Paillaud
E
E
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D016543:Central Nervous System Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D013129:Spinal Puncture; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate