Panhypopituitarism apparently caused by hypophysitis masking a rapid development of a craniopharyngioma. A case report.
We report the case of a 39-year-old male presenting with panhypopituitarism and diabetes insipidus. MR imaging showed focal thickening of the pituitary infundibulum and infiltration of the anterior pituitary lobe, suggesting hypophysitis. Hormonal replacement therapy induced a pronounced amelioration of general well-being. Eight months later the subject developed visual disturbances. MR imaging now showed a cystic sellar mass. Surgical drainage was performed. A second operation was necessary six weeks Later because of recurrent visual field defects. Diagnosis of papillary craniopharyngioma was finally made. This case demonstrates the remarkably rapid development of a craniopharyngioma, which initial radiological appearance was suggestive of hypophysitis. It also emphasizes the need of repeat MR examination in case of unusual presentation of hypopituitarism.
Joosen
P
P
AZ Turnhout, Campus Sint-Jozef, Steenweg op Merksplas 44 2300 Turnhout. peggy.joosen@azstjozef-turnhout.be
Abrams
P
P
Verhelst
J
J
Parizel
P M
PM
Salgado
R
R
Abs
R
R
D000328:Adult; D003397:Craniopharyngioma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy