Endocrinology and Metabolism

A Case of Pituitary Abscess that was Difficult to Diagnose due to Repeated Symptomatic Responses to Every Corticosteroid Administration.: Jin Sun Jang, Jae Seung Yun, Jung Ah Shin, Min Hee Kim, Dong Jun Lim, Jae Hyung Cho, Kun Ho Yoon, Moo Il Kang, Bong Yun Cha, Ho Young Son, Yong Kil Hong; Endocrinol Metab. 2011;26(1):72-77. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.72

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Abstract PDF: Pituitary abscess is a rare pathology, but it is a potentially life-threatening condition. Therefore, timely intervention, including antibiotics and an operation, can prevent the morbidity and mortality in such cases. A 31-year-old woman, who was 16 months after her second delivery, presented with intermittent headache for 3 months. Amenorrhea, polyuria and polydipsia were noticed and the endocrinological hormone studies were compatible with panhypopituitarism and diabetes insipidus. Pituitary MRI demonstrated a 2.3 cm sized cystic mass with an upper small nodular lesion. Her symptoms such as headache and fever were repeatedly improved whenever corticosteroid was administered, which led us to suspect the diagnosis of an inflammatory condition like lymphocytic hypophysitis. During the hormone replacement therapy, her cystic pituitary mass had grown and her symptoms progressively worsened for another two months. The patient underwent trans-sphenoidal exploration and she turned out to have a pituitary abscess. At the 3-month follow-up, amenorrhea was noticed and her residual function of the pituitary was tested by a combined pituitary stimulation test. The results were compatible with panhypopituitarism. She received levothyroxine 100 microg, prednisolone 5 mg and desmopressin spray and she is being observed at the out-patient clinic. The authors experienced a patient with primary pituitary abscess that was confirmed pathologically and we report on its clinical course with a literature review.

A Case of Panhypopituitarism and Central Diabetes Insipidus Caused by Primary Central Nervous System Lymphoma.: Mi Sun Ahn, Soon Sun Kim, Tae Ho Kim, Seung Jin Han, Dae Jung Kim, Hugh Chul Kim, Se Hyuk Kim, Jae Ho Han, Ho Sung Kim, Yoon Sok Chung; J Korean Endocr Soc. 2008;23(4):260-265. Published online August 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.4.260

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Abstract PDF: Primary central nervous system (CNS) lymphoma is an uncommon neoplasm. However, the incidence of primary CNS lymphoma has increased more than 10-fold over the past three decades, and continues to accelerate. Currently, primary CNS lymphoma represents 4 to 7 percent of all newly diagnosed primary CNS tumors. Primary CNS lymphoma may arise from different parts of the brain, with deep hemispheric periventricular white matter being the most common site of origin. The presenting symptoms in primary CNS lymphoma vary depending on the location of the mass. Involvement of the hypothalamic-pituitary axis may cause hypopituitarism, diabetes insipidus, headache, diplopia, and blurred vision.

A Case of Pituitary Metastasis of Breast Cancer Presenting as Diabetes Insipidus and Panhypopituitarism.: Jae Wuk Kwak, Byung Soo Jie, Sun Hwa Hong, Ji Hyun Kim, Seung Hwan Lee, Jae Hyung Jo, Hyuk Sang Kwon, Kun Ho Youn, Bong Yun Cha, Ho Young Son; J Korean Endocr Soc. 2007;22(2):125-129. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.125

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Abstract PDF

Metastasis to the pituitary gland from systemic cancer is a rare condition. The breast and lung are the most common sites of primary tumor metastasis. Pituitary metastasis may present with diabetes insipidus, cranial nerve palsy and hypopituitarism, and diabetes insipidus is the most frequent symptom at presentation. We report here on a 44 year-old woman with pituitary metastasis from breast cancer, and she developed central diabetes insipidus and hypopituitarism. The clinical diagnosis was made by performing a water deprivation test, a combined pituitary test and a MRI brain scan, and the latter showed metastatic tumor in the pituitary gland with invasion of the pituitary stalk. Symptomatic relief was obtained with administration of desmopressin; the urine osmolarity was increased with this treatment. We report here on a case of pituitary metastasis from breast cancer and the patient developed central diabetes insipidus and hypopituitarism. We also include a review of the relevant literature.

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A Case of Pituitary Metastasis from Breast Cancer That Presented as Left Visual Disturbance
Young Ha Kim, Beom jun Lee, Kyung Jin Lee, Jin Hee Cho
Journal of Korean Neurosurgical Society.2012; 51(2): 94. CrossRef
A Case of Panhypopituitarism and Central Diabetes Insipidus Caused by Primary Central Nervous System Lymphoma
Mi Sun Ahn, Soon Sun Kim, Tae Ho Kim, Seung Jin Han, Dae Jung Kim, Hugh Chul Kim, Se Hyuk Kim, Jae Ho Han, Ho Sung Kim, Yoon-Sok Chung
Journal of Korean Endocrine Society.2008; 23(4): 260. CrossRef

Primary Pituitary Abscess: An Unusual Case of Diabetes Insipidus.: Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek; J Korean Endocr Soc. 2006;21(5):408-413. Published online October 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.5.408

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Abstract PDF: A 58-year-old man was investigated for his complaints of chronic frontal headache. The endocrinologic hormone studies were compatible with diabetes insipidus and suggestive of panhypopituitarism. Sellar MRI showed a cystic sellar lesion with peripheral rim enhancement after contrast injection, and this led to an initial diagnosis of pituitary adenoma with hemorrhagic necrosis. He underwent an operation via the transsphenoidal approach to access the pituitary gland. During the operation, purulent materials were obtained and no tumor or other associated lesions were detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. All the cultures we obtained were negative. He was put on antibiotics and discharged after 4 weeks. Now, 18 months after treatment, he is doing well.

A Case of Panhypopituitarism with Rhabdomyolysis.: Sung Wook Hong, Eun Jung Lee, Ji Young Park, Ji Sung Yoon, Ji O Mok, Yeo Joo Kim, Hyeong Kyu Park, Jae Woo Kim, Chul Hee Kim, Sang Jin Kim, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo; J Korean Endocr Soc. 2005;20(2):174-178. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.174

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Abstract PDF: Rhabdomyolysis is the consequence of extensive muscle injury with the release of muscle cell constituents into plasma. It can arise from trauma and also from a variety of nontraumatic causes. Trauma, drugs, toxins and infection are the major causes of rhabdomyolysis, but it is rarely associated with metabolic disorders such as severe electrolyte disturbance, diabetic ketoacidosis, hyperosmolar nonketotic coma, hypothyroidism and thyrotoxicosis. There have been several reported cases of metabolic rhabdomyolysis, but panhypopituitarism as a cause has never been identified. We experienced a case of acute rhabdomyolysis associated with panhypopituitarism. Thus, So we report this case with the review of related literature. Metabolic disorder is a rare cause of rhabdomyolysis, but it should always be considered in a patient having and unexplained increased of the creatine kinase concentration

A Case of Panhypopituitarism Due to Craniopharyngioma with Slipped Capitalis Femoral Epiphysis.: Jun Hee Lee, Kyung Rae Kim, Hi Yan Park, Jin Yang Ju, Young Duk Chae, Soo Jee Yoon, Ki Joong Kim, Woo Il Park, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2002;17(1):104-109. Published online February 1, 2002

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Abstract PDF: Craniopharyngioma accounts for 3% to 5% of intracranial tumors and is the second most common neoplasm in the sellar region. Panhypopituitarism associated with craniopharyngioma has been reported in 7% of all patients with craniopharyngioma. Slipped capital femoral epiphysis is the condition in which the femoral head slips downward and backward on the femoral neck at the epiphyseal plate due to growth disturbance of capital physis, the actual cause of which is unknown. It is a disease of adolescence, during which many physiologic hormonal changes occur. The clinical association between slipped capital femoral epiphysis and endocrine disease is well known. There have been four cases of slipped capital femoral epiphysis associated with endocrine disorders in Korea. This is the first Korean case report of slipped capital femoral epiphysis combined with craniopharyngioma caused by hypopituitarism

A Case of Synchronized Pineal and Suprasellar Germinoma.: Jae Wook Chung, Jin Ho Lee, Soo Jin Lee, Chang Young Ha, Jong Soo Kim, Yoon Sok Chung, Kwan Woo Lee, Hyeon Man Kim; J Korean Endocr Soc. 2000;15(4-5):591-594. Published online January 1, 2001

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Abstract PDF: Pineal germinomas are the most common intracranial germ cell tumor and occur in relatively young age, with 26% between 10 and 12, 65% between 10 and 21 and 95% before age 27. Patients with pineal germinoma present headache, lethargy, nausea, and vomiting which result from raised intracranial pressure and Parinaud's syndrome secondary to midbrain tectal compression, and rarely endocrine dysfunction such as diabetes insipidus (DI), panhypopituitarism, and precocious puberty. We experienced a case of pineal and suprasellar germinoma presenting with central diabetes insipidus and panhypopituitarism.

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