Empty sella syndrome in an adolescent

Empty sella syndrome (ESS) is a condition in which the sella turcica is partially or completely filled with cerebrospinal fluid resulting in a displacement of the normal pituitary. The condition is more common and benign in adults, although associated endocrine abnormalities have been reported. In children and adolescents, the syndrome is rare (27 reported cases), and the clinical picture is much less benign, with an increase in familial incidence, associated skeletal disorders, and endocrine abnormalities. Definitive diagnosis can be made by CT scan of the head. Our case report is of an adolescent who appeared clinically to have growth retardation and normal endocrine function. The CT scan of the head was compatible with ESS. Further follow-up showed improved growth rate. Although our patient did not appear to have symptoms related to ESS, based on the literature we agree that this syndrome is much less benign in children and adolescents than in adults.