Minim Invasive Neurosurg 2008; 51(3): 169-172
DOI: 10.1055/s-2008-1042436
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Granulomatous Hypophysistis Associated with Rathke’s Cleft Cyst: A Case Report

M. Murakami 1 , H. Nishioka 1 , H. Izawa 1 , Y. Ikeda 1 , J. Haraoka 1
  • 1Department of Neurosurgery, Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan
Further Information

Publication History

Publication Date:
02 June 2008 (online)

Abstract

Objective: The value of surgical intervention in the management of hypophysitis remains controversial.

Patent: We describe a 57-year-old man presenting with general fatigue persisting for three months. Endocrine examination revealed hypopituitarism and diabetes insipidus. Magnetic resonance (MR) imaging showed a dumbbell-shaped pituitary mass lesion without a cystic component. We partially removed the lesion via a transsphenoidal approach. Histological examination yielded the diagnosis of granulomatous hypophysitis associated with Rathke’s cleft cyst. No deterioration of pituitary function was observed postoperatively. Twenty months after the surgery, the lesion has spontaneously regressed on MR imaging, and he is doing well with continuing replacement therapy of hydrocortisone, levothyroxine and desmopressin acetate.

Conclusion: The diagnosis of hypophysitis, apart from typical lymphocytic hypophysitis, is difficult even with a surgical biopsy. Because a small specimen may lead to a diagnosis of non-specific hypophysitis, partial removal of the lesion is less invasive and recommended for preservation of the pituitary function.

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Correspondence

M. MurakamiMD 

Department of Neurosurgery

Tokyo Medical University

Hachioji Medical Center

1163 Tatemachi

Hachioji

193-0998 Tokyo

Japan

Phone: +81/42/665 56 11

Fax: +81/42/665 17 96

Email: mmurakam@tokyo-med.ac.jp

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