Pseudotumoral Lymphocytic Hypophysitis Successfully Treated by Corticosteroid Alone

Beressi, Nathalie; Cohen, R??gis; Beressi, J.P.; Dumas, Jean-Luc; Legrand, Maggy; Iba-Zizen, Marie-Th??r??se; Modigliani, E

doi:10.1097/00006123-199409000-00020

Cited by 9 publications

(12 citation statements)

References 13 publications

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“…Our patient did have a thickened pituitary stalk at presentation. Most patients recover spontaneously and a trial of steroid therapy to aid resolution has been advocated 10 . Some patients, however, continue with a degree of residual hypopituitarism even though the pituitary has reduced in size.…”

Section: Discussionmentioning

confidence: 99%

Cystic Lymphocytic Hypophysitis, Visual Field Defects and Hypopituitarism

Rossi

Foy

et al. 1999

Int J Clinical Practice

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SUMMARYA 45‐year‐old man presented with anterior pituitary failure, requiring thyroxine, hydrocortisone and androgen replacement. An MRI scan revealed a large cystic pituitary mass and thickening of the pituitary stalk. Over three years, diabetes insipidus and bitemporal hemianopia developed and the cystic mass had enlarged on MR scanning. Transphenoidal resection was performed with normalisation of the visual fields. Histology revealed lymphocytic hypophysitis, which is rare in men. The presentation with cystic enlargement is unique.

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Section: Discussionmentioning

confidence: 99%

Cystic Lymphocytic Hypophysitis, Visual Field Defects and Hypopituitarism

Rossi

Foy

et al. 1999

Int J Clinical Practice

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“…Corticosteroids rapidly improved the effects of the mass, and pituitary function returned after glucocorticoid treatment in some patients 3,5,6,19,21 . However, for most patients, symptoms recurred during therapy or after reduction and withdrawal of corticosteroids 3,6,13,22 . Cases that did not respond to steroids have also been described 1,20,23 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Course of a Pituitary Macroadenoma in the First Trimester of Pregnancy: Probable Lymphocytic Hypophysitis

Özbey

Kahraman

Yilmaz

et al. 1999

Int J Clinical Practice

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SUMMARYRecent findings revealed that the clinical features of lymphocytic hypophysitis are more complicated than previously thought. It is rarely described in the first trimester of pregnancy and signs of meningeal irritation are infrequently reported. In this study, a pregnant woman in her first trimester of pregnancy with clinical and radiological characteristics of a pituitary macroadenoma is described. The patient's pituitary profile revealed a relatively low prolactin for her stage of pregnancy. Unusual findings were neck stiffness associated with headache, nausea and vomiting. She was treated conservatively. Spontaneous complete resolution of the pituitary mass in the postpartum period led us to conclude that the correct diagnosis should be hypophysitis. Hypophysitis should be considered in the differential diagnosis of a pituitary mass presenting in early stages of pregnancy with symptoms mimicking hyperemesis gravidarum and/or meningeal irritation.

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“…It has been proposed that the suspected inflammatory lesions of the pituitary should be managed conservatively to obviate the need of surgery (Beressi et al, 1994). In case of progressive compression, which causes optometric deterioration during conservative management, the trans-sphenoidal surgery is both diagnostic and therapeutic treatments and should be performed as soon as possible (Scanarini et al, 1989).…”

Section: Casementioning

confidence: 99%

“…Therefore, a considerable number of GRH cases were initially misdiagnosed as adenoma and then inappropriately received surgery therapy (Bhansali et al, 2004). Indeed, Beressi et al(1994) reported that steroid alone was successfully used to Journal of Zhejiang University SCIENCE B ISSN 1673-1581 (Print); ISSN 1862-1783 (Online) www.zju.edu.cn/jzus; www.springerlink.com E-mail: jzus@zju.edu.cn treat LYH in 1994. After that, a GRH due to Wegener's granulomatosis allowed successful medical management and helped avoid surgery (Goyal et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Granulomatous hypophysitis: two case reports and literature review

Shi

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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Granulomatous hypophysitis (GRH) is extremely rare and commonly presents with chronic inflammatory of the enlarged pituitary gland. In our study, 66-year-old and 57-year-old women, both Chinese, were diagnosed with GRH presenting preoperatively definite imageology characters as pituitary adenoma. The 66-year-old woman presented with a year of headache, half a year of gradual decrease of visual acuity, and one month of right ptosis. Serum prolactin level was slightly elevated. Screening computed tomography (CT) scanning revealed typical low density mass found on the enlarged sella, which demonstrated invasive extension from the sella to the right cavernous sinus by contrast enhanced magnetic resonance imaging (MRI). Consequently, the patient was diagnosed with probable invasive pituitary adenoma. The other 57-year-old woman complained a light headache and had been previously treated as nonfunctional pituitary adenoma in other hospital. Finally these two patients underwent transsphenoidal microsurgery and were diagnosed with GRH according to postoperative histopathology. They then were treated with steroid. During the follow-up, the clinical symptoms such as headache, visual damage, and ptosis vanished, and the mass of the sellae dramatically shrank on repeated MR images. Clinically and radiologically, GRH is a rare sellar entity easily to be misdiagnosed as a pituitary adenoma. Trans-sphenoidal surgery can decompress the optical nerve or oculomotornerve as a therapeutic strategy, and support biopsy or further pathological diagnosis. However, the hormonal therapy should be emphasized both as diagnostic and therapeutic strategies. Conservative and tentative steroid treatment should be performed in preoperative period without acute nerve damage.

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Pseudotumoral Lymphocytic Hypophysitis Successfully Treated by Corticosteroid Alone

Cited by 9 publications

References 13 publications

Cystic Lymphocytic Hypophysitis, Visual Field Defects and Hypopituitarism

Cystic Lymphocytic Hypophysitis, Visual Field Defects and Hypopituitarism

Clinical Course of a Pituitary Macroadenoma in the First Trimester of Pregnancy: Probable Lymphocytic Hypophysitis

Granulomatous hypophysitis: two case reports and literature review

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