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Necrotizing infundibulo-hypophysitis: case-report and literature review.
Carlos Magalhães-Ribeiro1, Antónia Furtado2, Raúl Baggen Santos1
1Department of Neurosurgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
British Journal of Neurosurgery
|June 21, 2021
Summary
Necrotizing infundibulo-hypophysitis (NIH) is a rare pituitary condition. This case highlights an indolent presentation without progression to panhypopituitarism, emphasizing surgical and histopathological diagnosis.
Area of Science:
- Endocrinology
- Neuropathology
- Neurosurgery
Background:
- Necrotizing infundibulo-hypophysitis (NIH) is an inflammatory condition affecting the pituitary gland and infundibulum.
- It is characterized by inflammation, necrosis, and often presents with hypopituitarism and central diabetes insipidus.
Observation:
- A 40-year-old female presented with central diabetes insipidus and hypopituitarism.
- Imaging revealed a thickened infundibulum and an enlarged pituitary mass with rim enhancement.
- The patient underwent microsurgical endonasal transsphenoidal resection.
Findings:
- Histopathology confirmed NIH, showing extensive liquefactive necrosis with lymphoplasmocytic infiltrate.
- This represents the fifth reported case of NIH and the first with an indolent course.
- Post-operative imaging showed no recurrence, and no progression to panhypopituitarism was observed.
Implications:
- Surgical resection and histopathological confirmation are crucial for diagnosing NIH.
- This case suggests that NIH can have an indolent course and may not always progress to panhypopituitarism.
- Further research into the varied clinical presentations and long-term outcomes of NIH is warranted.
