CASE 13076 Published on 12.10.2015
0

Pituitary dwarf with ectopic neurohypophysis

Section

Neuroradiology

Case Type

Clinical Cases

Authors

Suprava Naik, Gurucharan S Shetty, Alok K Udiya, Vishwaroop Bhattacharyya, Hiralal

Sanjay Gandhi Post-Graduate Institute
of Medical Sciences (UP) India
Sgpgims
Radiodiagnosis
Raibareli road
226014 Lucknow
Email:alok.udiya@gmail.com
Connected authors
Patient

11 years, male

Categories
Area of Interest Neuroradiology brain ; Imaging Technique MR
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Clinical History
Eleven year old child presented with short stature. Clinical examination revealed small scrotal sac. USG abdomen and scrotum was done, which showed reduced volume of bilateral testis. X-ray of wrist and elbow showed delayed bone age. Endocrinological evaluation revealed growth hormone deficiency. The patient underwent MRI brain and sella for further evaluation.
Imaging Findings
Posterior pituitary bright spot is seen at the level of median eminence. This is suggestive of ectopic posterior pituitary. Pituitary stalk is thin or absent and adenohypophysis is small in size.
Discussion
Hypopituitarism is the clinical syndrome caused by the deficiency of adenohypophyseal trophic hormones. [1] An uncommon cause of this condition is pituitary stalk interruption syndrome. The characteristic findings are small anterior pituitary gland, absent or ectopic posterior pituitary bright spot and absent or hypoplastic pituitary stalk. The diagnosis of hypoplastic anterior pituitary is made when the height of the gland is less than 2 mm. [2]
Afflicted individuals may present with single or multiple pituitary hormone deficiencies. The exact aetiology is not known but is believed to be due to ischaemic perinatal insult commonly following breech delivery. [3] Another hypothesis is that congenital hypoplasia or dysplasia of the pituitary gland leads to improper descent of the hypophyseal structure and its vascular plexus into the sella as the cause of hypo-pituitarism. [4] The advent of MRI and its widespread use has led to the increased recognition of this condition.
Differential Diagnosis List
Pituitary stalk transaction syndrome
Ectopic pitutary
Lipoma
Final Diagnosis
Pituitary stalk transaction syndrome
Case information
URL: https://www.eurorad.org/case/13076
DOI: 10.1594/EURORAD/CASE.13076
ISSN: 1563-4086
License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Figure 1

Pituitary dwarf with ectopic neurohypophysis

Pituitary dwarf with ectopic neurohypophysis
Posterior pituitary bright spot is seen at the level of median eminence. This is suggestive of ectopic posterior pituitary. Pituitary stalk is thin or absent and adenohypophysis is small in size.