TY - JOUR
TI - Hypophysitis superimposed on a non-functioning pituitary adenoma: Diagnostic clinical, endocrine and radiologic features
AU - Ballian, N.
AU - Chrisoulidou, A.
AU - Nomikos, P.
AU - Samara, C.
AU - Kontogeorgos, G.
AU - Kaltsas, G.A.
JO - Journal of Endocrinological Investigation
PY - 2007
VL - 30
TODO - 8
SP - 677-683
PB - Editrice Kurtis s.r.l.
SN - 0391-4097, 1720-8386
TODO - 10.1007/BF03347449
TODO - growth hormone;  hypophysis hormone, adult;  article;  case report;  clinical feature;  conservative treatment;  endocrine system examination;  female;  histopathology;  hormone substitution;  human;  hypogonadotropic hypogonadism;  hypophysis adenoma;  hypophysitis;  neurohypophysis disease;  nuclear magnetic resonance imaging;  optic chiasm;  postoperative period;  transsphenoidal surgery;  adenoma;  hypophysis tumor;  hypopituitarism;  immunology;  inflammation;  metabolism;  nuclear magnetic resonance imaging;  pathology, Adenoma;  Adult;  Female;  Humans;  Hypopituitarism;  Inflammation;  Magnetic Resonance Imaging;  Pituitary Hormones;  Pituitary Neoplasms
TODO - Pituitary adenomas are common neoplasms requiring medical and/or surgical treatment when associated with hormonal hypersecretion. Treatment of non-functioning pituitary adenomas is necessary when symptoms of mass effect or hormonal deficits occur. However, therapeutic options, including surgical resection and/or radiotherapy, can be associated with significant complications. Hence, it is important to consider disorders that could present in a similar manner to pituitary adenomas, for which surgery is not the indicated therapeutic approach. We describe herein a 38-yr-old woman who presented with a pituitary lesion that was considered to be a non-functioning pituitary adenoma. Due to lack of hormonal deficits and/or compression of adjacent structures, we opted for conservative management and follow-up with consecutive magnetic resonance imaging. Fifteen months after initial diagnosis, considerable enlargement of the lesion was noted, extending mainly superiorly and indenting the optic chiasm. Repeated endocrine investigation revealed par. tial anterior pituitary insufficiency. The patient underwent trans-sphenoidal resection of the pituitary lesion; histology revealed a null cell pituitary adenoma and lymphocytic hypophysitis (LYH) of the non-neoplastic adenohypophysial gland. Post-operatively, complete anterior and partial posterior pituitary insufficiency developed. This case illustrates the effects of new-onset LYH in a patient with a pre-existing non-functioning pituitary adenoma. Being aware of this rare possibility is important, as enlargement of the pituitary lesion may not be caused by expansion of the preexisting tumor, but by the onset of LYH of the non-neoplastic pituitary tissue. ©2007, Editrice Kurtis.
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