title: An unusual suspect causing behavioural problems and pituitary failure in a child.
abstract: A 9-year-old boy presented with feeding and behavioural problems and was diagnosed with Autistic Spectrum Disorder and Attention Deficit Hyperactivity Disorder. By age 11 he was becoming increasingly disinhibited and was refusing almost all oral food intake. Believing the cause to be psychogenic, he was placed in an inpatient eating disorder facility. After 3 days of continuous vomiting and minimal intake, he was admitted back to hospital for further investigations. A hypovolaemic hypernatraemia prompted an MRI brain scan, revealing several tumour masses with suprasellar and pituitary involvement. Histological investigation revealed primary, non-malignant germ-cell tumours. The tumours were treated with craniopharyngeal radiotherapy and permanent pituitary hormone replacement.
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, Norfolk,  UK.
authors.forename: Adam Charles
authors.initials: AC
authors.lastname: Heathcote
authors.forename: Justin Conrad Rosen
authors.initials: JC
authors.lastname: Wormald
authors.forename: Richard
authors.initials: R
authors.lastname: Stocks
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D001321:Autistic Disorder / Q000150:complications; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D019959:Feeding and Eating Disorders of Childhood / Q000209:etiology*; D018237:Germinoma / Q000150:complications* / Q000175:diagnosis / Q000532:radiotherapy; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male