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Cushing's disease due to a giant pituitary adenoma in early infancy: CT and MRI features
P Maeder1, F Gudinchet, B Rillet
1Department of Radiology, Centre Hospitalier Universitaire Vaudois, CH-1011 Lausanne, Switzerland.
Insights
A rare case of a 12-month-old girl with diabetes insipidus and Cushing's disease is presented. The cause was an adrenocorticotrophin (ACTH) secreting pituitary adenoma, with unique MRI findings for this age group.
Area of Science:
- Pediatric Endocrinology
- Neuro-oncology
- Pituitary Disorders
Background:
- Cushing's disease and diabetes insipidus are rare in infants.
- Pituitary adenomas are uncommon in children, especially ACTH-secreting types.
Observation:
- A 12-month-old girl presented with symptoms of both diabetes insipidus and Cushing's disease.
- Brain MRI revealed a large sellar tumor extending superiorly and invading cavernous sinuses.
Findings:
- Histological analysis confirmed an adrenocorticotrophin (ACTH) secreting pituitary adenoma.
- The tumor's size, location, and MRI characteristics were highly unusual for this pediatric age group.
Implications:
- This case highlights the importance of considering rare pituitary tumors in infants with complex endocrine and neurological symptoms.
- The unique MRI features described may aid in the early diagnosis of similar pediatric cases.
- Further research into the specific presentation and management of pediatric ACTH-secreting pituitary adenomas is warranted.
Abstract:
We report the case of a 12-month-old girl presenting with diabetes insipidus and Cushing s disease. Brain magnetic resonance imaging (MRI) demonstrated a large tumour arising from the sella turcica, extending up to the foramen of Monro and invading the cavernous sinuses. Surgery was performed to remove the suprasellar part of the tumour, and histology revealed an adrenocorticotrophin (ACTH) secreting pituitary adenoma. This entity is very rare in this age group and the MRI features have not previously been described.