An unusual suspect causing behavioural problems and pituitary failure in a child

Abstract

A 9-year-old boy presented with feeding and behavioural problems and was diagnosed with Autistic Spectrum Disorder and Attention Deficit Hyperactivity Disorder. By age 11 he was becoming increasingly disinhibited and was refusing almost all oral food intake. Believing the cause to be psychogenic, he was placed in an inpatient eating disorder facility. After 3 days of continuous vomiting and minimal intake, he was admitted back to hospital for further investigations. A hypovolaemic hypernatraemia prompted an MRI brain scan, revealing several tumour masses with suprasellar and pituitary involvement. Histological investigation revealed primary, non-malignant germ-cell tumours. The tumours were treated with craniopharyngeal radiotherapy and permanent pituitary hormone replacement. BACKGROUND

Psychiatric manifestations as initial presentation for pediatric CNS germ cell tumors, a case series

“…Previously reported case reports highlighted patients who presented with psychiatric symptoms and were all found to have atypical imaging characteristics with deep gray matter involvement and infiltrating nature 4-8 . Crawford et al published a report on presentation of CNS germ cell tumors with relation to location, as well.…”