title: Clinical and radiological features of pituitary stalk lesions in children and adolescents.
abstract: OBJECTIVE
  The diagnosis of pituitary stalk lesion has been based on clinical feature, radiologic assessment for its critical location and role. This study aimed to investigate clinical symptoms, endocrine disturbance, magnetic resonance imaging (MRI) findings of pituitary stalk lesions in children and adolescents and to evaluate differences between neoplastic lesions with the others.
  
  
  METHODS
  We performed a retrospective review of patients under 18 years old with pituitary stalk lesions diagnosed at the Seoul National University Children's Hospital between 2000 and 2013, by a text search for head MRI reports by using 'pituitary stalk', 'infundibulum', and 'infundibular stalk', as keywords.
  
  
  RESULTS
  For the 76 patients, sixteen patients (21.1%) had congenital lesions, and 52 (68.4%) had neoplasms. No inflammatory lesions were found. Diabetes insipidus (DI) was the most common endocrine defect, diagnosed in 38 patients (50%). There was male predominance especially in neoplastic group. Thickened pituitary stalk was, but enhancement of lesion was not, associated with neoplasm. DI was more prevalent in neoplastic stalk lesions. Anterior pituitary dysfunction such as growth hormone and adrenocorticotropic hormone deficiencies were less prevalent in neoplastic lesions of pituitary stalk.
  
  
  CONCLUSIONS
  In conclusion, the etiology of pituitary stalk lesions in children and adolescents is diverse and different from that in adults. Neoplastic pituitary stalk lesions can be differentiated from nonneoplastic lesions by systemic evaluation of clinical, hormonal, radiological findings.
authors: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Sung Chul
authors: SC
authors: Yoon
authors: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Choong Ho
authors: CH
authors: Shin
authors: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Sei Won
authors: SW
authors: Yang
authors: Department of Pediatrics, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors: Seong Yong
authors: SY
authors: Lee
keywords: Adolescent; Child; Pituitary gland; Pituitary hormones
references: Rheumatology (Oxford). 2014 Aug;53(8):1359-68
references: 24324213
references: N Engl J Med. 2007 Nov 22;357(21):2153-65
references: 18032765
references: AJR Am J Roentgenol. 2007 Mar;188(3):W223-32
references: 17312027
references: J Clin Endocrinol Metab. 2013 May;98(5):1812-8
references: 23533231
references: Brain Dev. 2007 Sep;29(8):514-8
references: 17307323
references: AJR Am J Roentgenol. 1992 Aug;159(2):375-7
references: 1632360
references: Can J Neurol Sci. 2009 Nov;36(6):783-6
references: 19960762
references: Neurologist. 2012 Nov;18(6):373-7
references: 23114669
references: Pediatrics. 2003 Dec;112(6 Pt 1):e480-6
references: 14654650
references: J Neurosurg. 2005 Aug;103(2 Suppl):142-7
references: 16370280
references: Curr Opin Endocrinol Diabetes Obes. 2008 Aug;15(4):339-45
references: 18594274
references: Medicine (Baltimore). 2007 Sep;86(5):259-68
references: 17873755
references: J Clin Endocrinol Metab. 2014 Apr;99(4):1264-72
references: 24276447
references: J Clin Endocrinol Metab. 2011 Sep;96(9):E1352-60
references: 21752883
references: Sarcoidosis. 1995 Mar;12(1):61-7
references: 7617979
references: Acta Neurol Scand. 1986 Mar;73(3):283-90
references: 3716768