Endocrine Aspects of Pituitary Stalk Enlargment

Abstract

Four patients with various endocrine deficiencies of a predominantly hypothalamic nature are described, in whom computed topographic scans demonstrated pituitary stalk enlargement. In one, a disseminated papular skin eruption with regional pleomorphism and spontaneous regression appeared 4 years after the development of the initial symptoms of diabetes insipidus, and led to a diagnosis of xanthoma disseminatum, a rare type of histiocytosis. It is suggested that this patient's endocrine dysfunction is also due to histiocytic involvement of the hypothalamus and/or pituitary stalk. In view of the prolonged lapse of time between the initial endocrine manifestations and the eventual diagnosis, even though no cause is apparent in the other three patients, it is suggested that close follow-up be carried out to rule out such a possibility in patients with this endocrine-radiological entity.

Xanthoma disseminatum with intracranial involvement: case report and literature review

“…Treatment of cutaneous and mucosal XD has been associated with varying degrees of success. Options including diet, 1,17 surgical excision, 1,4,7,9,18 electrocoagulation, 18 cryotherapy, 17 radiation, 1,5,19 glucocorticoids, 6,8,13,18,20,21 anti-metabolites, 5,20 anti-cancer drugs, 4,17,21,22 lipid lowering agents, 4,[23][24][25] or a combination of these therapies have been tried. 4,17,20,21 Some of these modalities have been used for intracranial lesions (Table 1).…”

Hypopituitarism and rare dermatological diseases: an intriguing case of xanthoma disseminatum

“…5 reported that skin eruptions appeared 4 years after the onset of diabetes insipidus in 1 / 4 patients with a thickened pituitary stalk. Diabetes insipidus occurs in about 40-50% of patients and can represent the first symptom of the disease.…”

“…Puig et al . 5 reported that skin eruptions appeared 4 years after the onset of diabetes insipidus in 1 / 4 patients with a thickened pituitary stalk. And Mahnel et al .…”