Document Detail

Suprasellar germinoma masquerading as lymphocytic hypophysitis associated with central diabetes insipidus, delayed sexual development, and subsequent hypopituitarism.
MedLine Citation:
PMID:  20051818     Owner:  NLM     Status:  MEDLINE    
We report the case of an 18-year-old woman with suprasellar germinoma masquerading as lymphocytic hypophysitis, which was associated with central diabetes insipidus, delayed sexual development, and hypopituitarism. Magnetic resonance imaging revealed an enlarged pituitary gland, thickened pituitary stalk, and a mass lesion in the inferior hypothalamus; these findings are typical of lymphocytic hypophysitis. Despite the administration of prednisolone therapy for 3 months, an enlarged irregular cystic mass lesion developed in the pituitary stalk and inferior hypothalamus. Open cranial surgery of the posterior pituitary revealed the presence of a germinoma. Therefore, chemotherapy and stereotactic radiation therapy were administered, resulting in complete remission of the germinoma. This case illustrates that the presence of an intrasellar mass lesion in association with pituitary stalk thickening can often cause difficulties in differential diagnosis. We believe that lymphocytic hypophysitis in pubertal children may be the first sign of a host reaction to an occult germinoma.
Takamasa Nishiuchi; Hitomi Imachi; Koji Murao; Mako Fujiwara; Makoto Sato; Yukiko Nishiuchi; Yoshio Kushida; Reiji Haba; Atsushi Shindo; Takashi Tamiya; Toshihiko Ishida
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  339     ISSN:  1538-2990     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-11     Completed Date:  2010-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  195-9     Citation Subset:  AIM; IM    
Department of Internal Medicine, Kagawa University, Japan.
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MeSH Terms
Antineoplastic Agents / administration & dosage,  therapeutic use
Carboplatin / administration & dosage,  therapeutic use
Diabetes Insipidus, Neurogenic / etiology*
Etoposide / administration & dosage,  therapeutic use
Germinoma / complications*,  drug therapy,  pathology*,  radiotherapy
Hypopituitarism / etiology*
Pituitary Diseases / pathology*
Puberty, Delayed / etiology*
Reg. No./Substance:
0/Antineoplastic Agents; 33419-42-0/Etoposide; 41575-94-4/Carboplatin

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