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Published on: January 17, 2018
A case of reversed pituitary dysfunction with intrasellar mass
1Division of Endocrinology and Metabolism, Department of Medicine II, Hokkaido University Graduate School of Medicine, 060-8638 Sapporo, Japan.
Journal of Endocrinological Investigation
|May 16, 2006
Summary
A rare intrasellar mass causing hypoadrenalism and central diabetes insipidus spontaneously resolved in a 61-year-old woman. This case highlights the potential for spontaneous reversal of pituitary dysfunction and mass shrinkage, suggesting an intrasellar hemangioma.
Area of Science:
- Endocrinology
- Neuroradiology
- Pathology
Background:
- Hypopituitarism, often caused by tumors or inflammation, typically requires lifelong hormone replacement therapy.
- Pituitary dysfunction necessitates medical intervention to manage hormone deficiencies.
Observation:
- A 61-year-old woman presented with hypoadrenalism and central diabetes insipidus (cDI).
- Magnetic resonance (MR) imaging revealed a unique intrasellar mass with specific signal characteristics.
- The pituitary lesion demonstrated isointensity on T1-weighted and high intensity on T2-weighted MR images, with gadolinium enhancement.
Findings:
- The patient received hormone replacement therapy with hydrocortisone and desmopressin acetate.
- Remarkably, a spontaneous improvement in pituitary function occurred within three months, alongside mass shrinkage.
- Both hydrocortisone and desmopressin acetate were discontinued as symptoms resolved and pituitary function normalized.
Implications:
- This case suggests that certain intrasellar masses, potentially hemangiomas, may undergo spontaneous resolution.
- The findings challenge the assumption of permanent pituitary dysfunction in all cases of intrasellar masses.
- Further investigation into the natural history and imaging features of such unique pituitary lesions is warranted.
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