Lymphocytic hypophysitis: report of a case in a man with cavernous sinus involvement

Lymphocytic hypophysitis (LH) is a rare inflammatory disease of the pituitary that produces hypopituitarism. It more commonly affects women during pregnancy or shortly after childbirth. Of the 34 reported cases only three have been males. We report the fourth known case of lymphocytic hypophysitis in a male who presented with hypopituitarism, diplopia, and cavernous sinus involvement. To our knowledge this is the second report of involvement of the cavernous sinus by LH. A comparative study of all four male cases is also presented. The findings reveal that the mean age at presentation in the male patients is 52.3, nearly 21 years older than that reported for female cases. Impotence with associated decrease in libido is the most common presenting symptom. Extraocular muscle palsy with associated infiltration of the cavernous sinus is an exclusive finding among male patients with LH. Concerning prognosis, none of the male patients regained pituitary function that had been lost at the time of presentation but required chronic replacement therapy.