Cerebral fluid sampling and pituitary stalk
biopsy were considered deferred.
Other causes of hyperprolactinemia were sorted into non-pituitary masses (n=6), craniopharyngioma (n=5), macroprolactinemia (n=5), hypothyroidism (n=3), polycystic ovary syndrome (n=2), pituitary stalk
interruption syndrome (PSIS) (n=2), rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysfunction syndrome (n=2) and tuberous sclerosis (n=1).
Other pituitary adenomas which not secrete prolactin may also cause hyperprolactinemia by compression of the pituitary stalk
. Likewise, conditions affecting the hypothalamus such as granulomatous disorders, gliomas, craniopharyngiomas, metastases, trauma, and cranial irradiation may also cause prolactin elevation.
Figure 1 shows spectacular skull base structures such as the pituitary gland, pituitary stalk
, branches of the circle of Willis, and the sellar region.
thickening, pituitary enlargement, intense homogeneous post-contrast imbibition in adenohypophysis, and absence of high-intense signal in neurohypophysis on T1-weighted images (3).
1 case (26/f) MRI-enhancing suprasellar mass (9 x 6 mm), thickening of pituitary stalk
. Layden et al.
(4) In terms of imaging findings, the most characteristic feature of a pituitary metastasis is enlargement or enhancement of the pituitary stalk
with a pituitary mass.
Post operative reversible diabetes insipid us appears to be either due to the surgical trauma or fall of diaphragm sella as the adenoma is removed resulting in stretching of pituitary stalk
.6 Temporary DI was treated in 3 (16.6%) patients and they all improved.
None was found except for abnormal brain MRI findings showing a thickened pituitary stalk
and absent high signal at the posterior lobe of pituitary on T1WI (figure not shown).
We present the unique case of a 34-year-old man with pituitary stalk
inflammation, secondary to a germ cell tumor.
compression, a common side effect of pituitary metastases, may lead to elevated prolactin.
An MRI showed only an anterior pituitary hypoplasia, while those for patients with genetic GHD generally reveal a normal or hypoplastic pituitary gland without abnormalities of the hypothalamus, pituitary dystopia, agenesis of the pituitary gland, or thinning or interruption of the pituitary stalk