Figure 1. Cranial magnetic resonance imaging (MRI). Post-contrast images of sellar mass at the diagnosis (a and b) and after radiotherapy (c).
| Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc |
| Journal website http://www.jofem.org |
Case Report
Volume 8, Number 5, October 2018, pages 113-118
A Case of Pituitary Germinoma Misdiagnosed as Lymphocytic Hypophysitis
Figures
Table
| Case report | Age | Sex | Clinical presentation | Hormonal evaluation | First MRI finding | First Bx lymphocitic infiltration ± granulomatous change or fibrosis | Tumor markers | IHC | Initial treatment | Time to final diagnosis |
|---|---|---|---|---|---|---|---|---|---|---|
| Panhypo: panhypopituitarism; DI: diabetes insipidus; Wt: weight; Bx: biopsy; IHC: immunohistochemistry; PLAP: placental alkaline phosphatase; GC: glucocorticoid; NK: not known; Nd: not described. *In this case, the diagnosis of germinoma was confirmed by the first biopsy using IHC study. | ||||||||||
| Mikami-Terao et al (2006) [9] | 13 | Female | Polyuria, polydipsia, headache, pubertal arrest | Panhypo DI | Enlarged pituitary, mass lesion in the stalk | Yes | Negative | First Bx: CD20, CD79, CD3, CD5, CD45 Second Bx: PLAP | GC | > 24 months |
| Terasaka et al (2012) [28] | 40 | Female | Polyuria, polydipsia, amenorrhea, headache, double vision, Wt loss, nerve palsy | Panhypo DI | Intrasellar mass, stalk thickening | Yes (fibrosis) | Negative | First Bx: CD3, CD20 Second Bx: PLAP, c-kit | GC | 84 months |
| Fehn et al (1999) [29] | 12 | Female | Polyuria, polydipsia, growth retardation, headache, visual loss | Panhypo DI | Normal | Yes (fibrosis) | Negative | Second Bx: CD43, CD45, CD20 Third Bx: PLAP | GC | 72 months |
| Gutenberg et al (2011) [33] | 11 | Female | Blurred vision, fatigue, polyuria, polydipsia | Panhypo DI | Intra- and suprasellar mass | Yes | Negative | First Bx: CD79, CD3 Second Bx: c-kit, Oct4 | GC | 30 months |
| Endo et al (2002) [30] | 12 | Male | Polyuria, polydipsia, fatigue, loss of appetite | Panhypo DI | Intrasellar mass with suprasellar extension and right cavernous invasion | Yes (granulomatous change) | Negative | First Bx: Nd Second Bx: PLAP | GC | 30 months |
| Bettendorf et al (1999) [31] | 8 | Female | Polyuria, polydipsia, short stature | Panhypo DI | Normal | Yes | Negative | Nd | GC | 77 months |
| Amat Madramany et al (2015) [32] | 10 | Male | Polyuria, polydipsia | Panhypo DI | Normal | Diagnosis: lymphocytic hypophysitis | Negative | NK | NK | 36 months |
| Houdouin* et al (2003) [12] | 13 | Male | Polyuria, polydipsia, visual field defect | Panhypo DI | Normal | Diagnosis: lymphocytic hypophysitis | NK | First Bx: PLAP, c-kit | NK | NK |
| Houdouin* et al (2003) [12] | 21 | Male | Polyuria, polydipsia, visual field defect | Panhypo DI | Stalk thickening | Diagnosis: lymphocytic hypophysitis | NK | First Bx: PLAP, c-kit | NK | NK |