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A rare case of pituitary infarction leading to spontaneous tumour resolution and CSF-sella syndrome in an 11-year-old girl and a review of the paediatric literature

  • Vicki E. Maltby , Patricia A. Crock EMAIL logo and Dieter K. Lüdecke
Published/Copyright: May 23, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 9-10

Abstract

Pituitary infarction or apoplexy with spontaneous cure of the underlying pituitary adenoma is rare. In the paediatric population, we found only a few reported cases. We report a rare case of pituitary infarction progressing to CSF-sella syndrome (or empty sella) in an 11-year-old girl. She presented with sudden onset vomiting, moderate headaches, lethargy, weight loss, and tall stature above her mid-parental height. She did not have any severe symptoms of apoplexy. Her clinical and radiological findings suggested infarction of a pituitary lesion, such as a pituitary adenoma or infarction of a cystic lesion, such as a Rathke’s cleft cyst. In this report, we discuss her case of probable infarction of a growth hormone secreting adenoma with a phase of accelerated growth ending up with total anterior pituitary insufficiency. The differential diagnosis and review of the rare cases of paediatric pituitary infarction in the literature will be discussed.

Keywords: apoplexy; CSF-sella syndrome; gigantism; lymphocytic hypophysitis; pituitary; pituitary infarction
Corresponding author: Patricia A. Crock, Department of Paediatric Endocrinology and Diabetes, John Hunter Children’s Hospital, New Lambton Heights, NSW, Australia; and Centre for Information Based Medicine, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia, Phone: + 61 (02) 4985 5634, Fax: + 61 (02) 4921 3599, E-mail:
aVicki E. Maltby and Patricia A. Crock contributed equally to this work.

Acknowledgments

No specific funding was received for this article.

Conflicts of interest statement

The authors declare no potential conflicts of interests with respect to this authorship and/or the publication of this article.

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Received: 2014-4-3
Accepted: 2014-4-16
Published Online: 2014-5-23
Published in Print: 2014-9-20

©2014 by De Gruyter

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  1. Frontmatter
  2. Review article
  3. Towards an optimization of the management of endocrine complications of thalassemia
  4. Original articles
  5. The natural course of Hashimoto’s thyroiditis in children and adolescents
  6. Muscle strength and body composition during the transition phase in patients treated with recombinant GH to final height
  7. Benign vaginal bleeding in 24 prepubertal patients: clinical, biochemical and imaging features
  8. Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
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  11. A novel CASR mutation associated with neonatal severe hyperparathyroidism transmitted as an autosomal recessive disorder
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  13. Adult human liver mesenchymal progenitor cells express phenylalanine hydroxylase
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  15. Hereditary 1,25-dihydroxyvitamin D-resistant rickets with alopecia in four Egyptian families: report of three novel mutations in the vitamin D receptor gene
  16. Permanent neonatal diabetes mellitus in Jordan
  17. The effect of adenotonsilectomy on ghrelin, leptin, IGF-1 levels and growth parameters in children with adenotonsillar hypertrophy
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https://doi.org/10.1515/jpem-2014-0143
Keywords for this article
apoplexy; CSF-sella syndrome; gigantism; lymphocytic hypophysitis; pituitary; pituitary infarction

Articles in the same Issue

  1. Frontmatter
  2. Review article
  3. Towards an optimization of the management of endocrine complications of thalassemia
  4. Original articles
  5. The natural course of Hashimoto’s thyroiditis in children and adolescents
  6. Muscle strength and body composition during the transition phase in patients treated with recombinant GH to final height
  7. Benign vaginal bleeding in 24 prepubertal patients: clinical, biochemical and imaging features
  8. Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents
  9. Counseling patients with succinate dehydrogenase subunit defects: genetics, preventive guidelines, and dealing with uncertainty
  10. Pubertal development profile in patients with Turner syndrome
  11. A novel CASR mutation associated with neonatal severe hyperparathyroidism transmitted as an autosomal recessive disorder
  12. Serum insulin-like growth factor-binding protein-3 level correlated with glycemic control and lipid profiles in children and adolescents with type 1 diabetes
  13. Adult human liver mesenchymal progenitor cells express phenylalanine hydroxylase
  14. Clinical applicability of rapid detection of SRY and DYS14 genes in patients with disorders of sex development using an indigenously developed 5′ exonuclease based assay
  15. Hereditary 1,25-dihydroxyvitamin D-resistant rickets with alopecia in four Egyptian families: report of three novel mutations in the vitamin D receptor gene
  16. Permanent neonatal diabetes mellitus in Jordan
  17. The effect of adenotonsilectomy on ghrelin, leptin, IGF-1 levels and growth parameters in children with adenotonsillar hypertrophy
  18. The role of anti-Mullerian and inhibin B hormones in the evaluation of 46,XY disorders of sex development
  19. The evaluation of thyroid carcinoma in childhood and concomitance of autoimmune thyroid disorders
  20. Lipid patterns in treated growth hormone deficient children vs. short stature controls
  21. Assessment of aortic morphology and compliance in children and adolescents with Ullrich-Turner syndrome (UTS) using magnetic resonance imaging (MRI)
  22. Management of central diabetes insipidus with oral desmopressin lyophilisate in infants
  23. Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone
  24. Patient reports
  25. A rare case of pituitary infarction leading to spontaneous tumour resolution and CSF-sella syndrome in an 11-year-old girl and a review of the paediatric literature
  26. Rare case of homozygous epimerase deficiency and heterozygous of duarte 2 variant
  27. Persistent congenital hyperinsulinism in two patients with Beckwith-Wiedemann syndrome due to mosaic uniparental disomy 11p
  28. Growth hormone treatment in a patient with Hurler-Scheie syndrome
  29. Neonatal diagnosis of a patient with hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR) syndrome associated with cerebral infarction
  30. Early-onset diabetes mellitus and neurodevelopmental retardation: the first Greek case of Wolcott-Rallison syndrome
  31. Type III Bartter-like syndrome in an infant boy with Gitelman syndrome and autosomal dominant familial neurohypophyseal diabetes insipidus
  32. Cushing’s syndrome: hidden risk in usage of topical corticosteroids
  33. Prader-Willi syndrome: a case report with atypical developmental features
  34. Berardinelli-Seip congenital lipodystrophy: an autosomal recessive disorder with rare association of duodenocolonic polyps
  35. Ectopic Cushing syndrome secondary to metastatic medullary thyroid cancer in a child with multiple endocrine neoplasia syndrome type 2B: clues to early diagnosis of the paraneoplastic syndromes
  36. Ovarian hyperstimulation syndrome treated by medroxyprogesterone acetate
  37. Symptomatic cerebral infarction in a child with severe diabetic ketoacidosis
  38. A rare case of familial Cushing’s syndrome with a common presentation of weight gain due to a mutation of the PRKAR1A gene causing isolated primary pigmented nodular adrenocortical disease
  39. Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: is there an association? A case report and literature review
  40. Cholestasis and protein-losing enteropathy secondary to hyperthyroidism in a 6-year-old girl
  41. Short communication
  42. An essential splice site mutation (c.317+1G>A) in the TSHR gene leads to severe thyroid dysgenesis
  43. Letter to the Editor
  44. Pubertal gynecomastia: what about the remaining 10%?
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