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Lymphocytic hypophysitis with central diabetes insipidus and subsequent hypopituitarism masking a suprasellar germinoma in a 13-year-old girl

  • Case Report
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Abstract

Case report

We report a case of central diabetes insipidus, hypothyroidism, and subsequent hypopituitarism due to lymphocytic hypophysitis masking a germinoma in a 13-year-old pubertal girl. Magnetic resonance revealed an enlarged pituitary gland and a mass lesion in the pituitary stalk and inferior hypothalamus. Open cranial surgery of the anterior pituitary showed active hypophysitis with lymphocytic infiltrates but without necrosis. Despite prednisolone therapy, 1 year later an enlarged, irregular cystic mass lesion had developed; in the pituitary stalk and inferior hypothalamus, a endoscopic biopsy revealed germinoma.

Conclusion

Lymphocytic hypophysitis in children may be the first sign of a host reaction to an occult germinoma. The diagnosis of central diabetes insipidus with a thickened pituitary stalk requires long-term follow-up to establish the underlying cause.

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Authors and Affiliations

  1. Department of Pediatrics, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Yoko Mikami-Terao, Masaharu Akiyama, Takaaki Yanagisawa, Kentaro Yokoi, Kohei Fukuoka, Mio Sakuma, Ichiro Miyata, Kohji Fujisawa & Yoshikatsu Eto

  2. Division of Pediatric Neurosurgery, Jikei University School of Medicine, Tokyo, Japan

    Shizuo Oi

  3. Division of Neuropathology, Jikei University School of Medicine, Tokyo, Japan

    Junko Takahashi-Fujigasaki

Authors
  1. Yoko Mikami-Terao
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  2. Masaharu Akiyama
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  3. Takaaki Yanagisawa
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  4. Junko Takahashi-Fujigasaki
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  5. Kentaro Yokoi
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  6. Kohei Fukuoka
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  7. Mio Sakuma
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  8. Ichiro Miyata
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  9. Kohji Fujisawa
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  10. Shizuo Oi
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  11. Yoshikatsu Eto
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Corresponding author

Correspondence to Masaharu Akiyama.

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Mikami-Terao, Y., Akiyama, M., Yanagisawa, T. et al. Lymphocytic hypophysitis with central diabetes insipidus and subsequent hypopituitarism masking a suprasellar germinoma in a 13-year-old girl. Childs Nerv Syst 22, 1338–1343 (2006). https://doi.org/10.1007/s00381-006-0078-7

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  • DOI: https://doi.org/10.1007/s00381-006-0078-7

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