title: Duplication of the pituitary gland associated with multiple blastogenesis defects: Duplication of the pituitary gland (DPG)-plus syndrome. Case report and review of literature.
abstract: BACKGROUND
  Duplication of the pituitary gland (DPG) is a rare craniofacial developmental anomaly occurring during blastogenesis with postulated etiology such as incomplete twinning, teratogens, median cleft face syndrome or splitting of the notochord. The complex craniocaudal spectrum of blastogenesis defects associated with DPG is examined with an illustrative case.
  
  
  METHODS
  We report for the first time in the medical literature some unique associations with DPG, such as a clival encephalocele, third cerebral peduncle, duplicate odontoid process and a double tongue with independent volitional control. This patient also has the previously reported common associations such as duplicated sella, cleft palate, hypertelorism, callosal agenesis, hypothalamic enlargement, nasopharyngeal teratoma, fenestrated basilar artery and supernumerary teeth. This study also reviews 37 cases of DPG identified through MEDLINE literature search from 1880 to 2011. It provides a detailed analysis of the current case through physical examination and imaging.
  
  
  CONCLUSIONS
  The authors propose that the developmental deformities associated with duplication of pituitary gland (DPG) occur as part of a developmental continuum, not as chance associations. Considering the fact that DPG is uniquely and certainly present throughout the spectrum of these blastogenesis defects, we suggest the term DPG-plus syndrome.
authors.affiliation: Division of Neurosurgery, MetroHealth Medical Center, Cleveland, Ohio.
authors.forename: Sunil
authors.initials: S
authors.lastname: Manjila
authors.forename: Erin A
authors.initials: EA
authors.lastname: Miller
authors.forename: Sumeet
authors.initials: S
authors.lastname: Vadera
authors.forename: Rishi K
authors.initials: RK
authors.lastname: Goel
authors.forename: Fahd R
authors.initials: FR
authors.lastname: Khan
authors.forename: Carol
authors.initials: C
authors.lastname: Crowe
authors.forename: Robert T
authors.initials: RT
authors.lastname: Geertman