Hypothalamic type of hypopituitarism and central diabetes insipidus probably linked to Rathke's cleft cyst

Intern Med. 2015;54(8):935-40. doi: 10.2169/internalmedicine.54.3289. Epub 2015 Apr 15.

Abstract

A 73-year-old woman was admitted due to weight loss and generalized malaise. The basal levels of all the anterior pituitary hormones, except for prolactin, were reduced. However, they were all elevated in response to exogenous hypothalamic hormones. After starting hydrocortisone replacement, the patient had polyuria of >5,000 mL/day. T1-weighted MRI depicted a low signal of an oval mass in the sella turcica and an iso-intense signal of another mass at the pituitary stalk. These findings indicate a hypothalamic type of hypopituitarism and masked central diabetes insipidus which possibly derived from the atypical occupation of Rathke's cleft cyst at the pituitary stalk.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use*
  • Central Nervous System Cysts / complications
  • Central Nervous System Cysts / pathology*
  • Diabetes Insipidus, Neurogenic / etiology
  • Diabetes Insipidus, Neurogenic / pathology*
  • Female
  • Humans
  • Hydrocortisone / therapeutic use*
  • Hypopituitarism / etiology
  • Hypopituitarism / pathology*
  • Magnetic Resonance Imaging*
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / pathology*

Substances

  • Anti-Inflammatory Agents
  • Hydrocortisone