Skip Navigation LinksHome > September 1997 - Volume 41 - Issue 3 > Recurrent Lymphocytic Hypophysitis: Case Report
Neurosurgery:
Case Reports

Recurrent Lymphocytic Hypophysitis: Case Report

Nishioka, Hiroshi MD; Ito, Hiroshi MD; Fukushima, Chikara MD

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Abstract

OBJECTIVE AND IMPORTANCE: Lymphocytic hypophysitis is being recognized with increasing frequency, but the long-term course is not well known. Recurrence of lymphocytic hypophysitis after a long interval has never been reported.

CLINICAL PRESENTATION: A 53-year-old woman presented with central diabetes insipidus. Magnetic resonance imaging (MRI) revealed an intrasellar lesion. Transsphenoidal biopsy yielded a diagnosis of lymphocytic hypophysitis. Regression of the lesion was confirmed by follow-up MRI. The patient lived normally, with gradual improvement of diabetes insipidus, until she suddenly became aware of a visual defect, which developed into bitemporal hemianopsia 2 years after the biopsy. MRI revealed a large sellar lesion extending to the hypothalamus. However, the adenohypophysial function remained normal and the mild diabetes insipidus continued unchanged.

INTERVENTION: Prompt corticosteroid treatment was remarkably effective. The visual defect disappeared during steroid therapy, and a significant reduction of the lesion was revealed by MRI.

CONCLUSION: It is suggested that long-term follow-up with endocrinological and radiological studies may be necessary in cases of lymphocytic hypophysitis. Recurrent cases should be promptly treated with steroids when a definitive histological diagnosis had been confirmed.

Copyright © by the Congress of Neurological Surgeons

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