[Polyuria and polydipsia in a young boy--a case study (author's transl)]

Area of Science:

• Pediatric Endocrinology
• Neurosurgery
• Oncology

Background:

• Presents a rare case of a 13-year-old boy with a sellar region teratoma.
• Highlights the diagnostic challenges in identifying sellar masses, especially in pediatric patients.

Observation:

• Initial symptoms included polyuria and polydipsia, indicative of pituitary dysfunction.
• Early neuroradiological imaging (CT) failed to detect a sellar mass, showing only ventricular enlargement.
• Delayed presentation with visual disturbances and mental disorders prompted further investigation.

Findings:

• Second admission revealed a suprasellar mass on skull films and CT, initially suspected as germinoma.
• Surgical exploration identified and completely removed a teratoma originating from the pituitary fossa.
• Histopathological analysis confirmed a tri-dermal teratoma with components of melanotic progonoma and germinoma.

Implications:

• Demonstrates the importance of comprehensive evaluation for persistent endocrine and neurological symptoms, even with initially negative imaging.
• Underscores the potential for teratomas to present insidiously with diverse clinical manifestations.
• Highlights successful surgical management and the diagnostic value of histopathology in complex sellar region tumors.