Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

  • Lorenzo Giammattei Department of Neurosurgery, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
  • Homajoun Maslehaty Department of Neurosurgery, University Hospitals Schleswig-Holstein, Campus Kiel, Germany University Medical Center, Germany.
  • Athanasios K. Petridis | opticdisc@aol.com Department of Neurosurgery, University Hospitals Schleswig-Holstein, Campus Kiel, Germany University Medical Center, Germany.
  • Hubertus Maximilian Mehdorn Department of Neurosurgery, University Hospitals Schleswig-Holstein, Campus Kiel, Germany University Medical Center, Germany.

Abstract

A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI) showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense), distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

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Author Biography

Athanasios K. Petridis, Department of Neurosurgery, University Hospitals Schleswig-Holstein, Campus Kiel, Germany University Medical Center
Staff Neurosurgeon, Neurosurgical Department, University Hospital Kiel, Germany
Published
2011-06-23
Section
Case Reports
Keywords:
hypophysitis, pituitary adenoma, endocrinology.
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How to Cite
Giammattei, L., Maslehaty, H., Petridis, A., & Mehdorn, H. (2011). Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma. Clinics and Practice, 1(3), e48. https://doi.org/10.4081/cp.2011.e48