Asymptomatic Empty Sella Syndrome: A "New" Hypothalamic Pathology or Paraphysiological Variant

Area of Science:

• Endocrinology
• Neuroimaging
• Radiology

Background:

• Empty sella refers to a pituitary gland that is shrunken or displaced.
• It can be primary (genetic) or secondary (trauma, surgery, radiation).
• While 50% of patients are asymptomatic, others experience symptoms like headaches or visual defects.

Purpose of the Study:

• To examine a rare case of asymptomatic empty sella syndrome.
• To discuss the diagnostic and therapeutic challenges associated with this condition.

Main Methods:

• A 67-year-old female patient with dilatative cardiomyopathy was evaluated.
• Magnetic resonance imaging (MRI) confirmed an empty sella.
• Blood tests revealed hypothyroidism, hypoadrenalism, and growth hormone (GH) deficiency.

Main Results:

• The patient had a known history of hormone deficiencies for over a decade without symptoms or complications.
• Despite stress and vascular procedures, she did not experience adrenal crisis or severe hypothyroidism.
• Hormonal replacement therapy was initiated.

Conclusions:

• Asymptomatic empty sella syndrome is rare, contrasting with typical presentations of hormone deficiency.
• The case suggests a potential hypothalamic dysfunction or a physiological variant.
• Further research is needed to determine optimal treatment strategies.