Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review
Objective. Intracranial germ cell tumors with isolated pituitary stalk involvement are rare. Early recognition and long-term monitoring deserve further exploration. Methods. A retrospective study reviewing eleven intracranial germ cell tumor patients with isolated pituitary stalk involvement was per...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2022/9213220 |
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| author | Han Chen Ming Ni Yun Xu Li-Yong Zhong |
| author_facet | Han Chen Ming Ni Yun Xu Li-Yong Zhong |
| author_sort | Han Chen |
| collection | DOAJ |
| description | Objective. Intracranial germ cell tumors with isolated pituitary stalk involvement are rare. Early recognition and long-term monitoring deserve further exploration. Methods. A retrospective study reviewing eleven intracranial germ cell tumor patients with isolated pituitary stalk involvement was performed. Results. Seven boys and four girls who presented with a hyperintense pituitary stalk on postcontrast T1-weighted magnetic resonance imaging without a posterior pituitary signal were included. The average maximum width of the pituitary stalk was 5.2 ± 1.6 mm. Polydipsia and polyuria occurred in all patients, followed by growth retardation, fatigue, and amenorrhoea. Eight patients (72%) had concomitant partial anterior pituitary hormone deficiency. Seven patients initially had elevated human chorionic gonadotropin levels. After chemoradiotherapy, ten patients attended follow-up. Central diabetes insipidus remained in all survivors, and four (40%) of them had concomitant partial anterior pituitary hormone deficiency, primarily of growth hormone and insulin-like growth factor-1. The causes of the delayed diagnosis of previous studies were mainly negative tumor markers and the initial pathological diagnosis of autoimmune diseases. Conclusion. Isolated pituitary stalk lesions could be a signal of intracranial germ cell tumors, especially coexisting with diabetes insipidus, hypopituitarism, and a worse response to glucocorticoid therapy. Negative results of tumor markers and pathology could not exclude the diagnosis. Chemoradiotherapy is an effective therapy, leaving mild-t-moderate hypothalamus-pituitary dysfunction. This rare neuroimaging feature may be used as a factor to predict long-term neuroendocrine outcomes. |
| format | Article |
| id | doaj-art-a3068aebbe394e0c962925a63265b8b8 |
| institution | Kabale University |
| issn | 1687-8345 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-a3068aebbe394e0c962925a63265b8b82025-02-03T01:09:53ZengWileyInternational Journal of Endocrinology1687-83452022-01-01202210.1155/2022/9213220Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature ReviewHan Chen0Ming Ni1Yun Xu2Li-Yong Zhong3Department of EndocrinologyDepartment of NeurosurgeryDepartment of Obstetrics and GynaecologyDepartment of EndocrinologyObjective. Intracranial germ cell tumors with isolated pituitary stalk involvement are rare. Early recognition and long-term monitoring deserve further exploration. Methods. A retrospective study reviewing eleven intracranial germ cell tumor patients with isolated pituitary stalk involvement was performed. Results. Seven boys and four girls who presented with a hyperintense pituitary stalk on postcontrast T1-weighted magnetic resonance imaging without a posterior pituitary signal were included. The average maximum width of the pituitary stalk was 5.2 ± 1.6 mm. Polydipsia and polyuria occurred in all patients, followed by growth retardation, fatigue, and amenorrhoea. Eight patients (72%) had concomitant partial anterior pituitary hormone deficiency. Seven patients initially had elevated human chorionic gonadotropin levels. After chemoradiotherapy, ten patients attended follow-up. Central diabetes insipidus remained in all survivors, and four (40%) of them had concomitant partial anterior pituitary hormone deficiency, primarily of growth hormone and insulin-like growth factor-1. The causes of the delayed diagnosis of previous studies were mainly negative tumor markers and the initial pathological diagnosis of autoimmune diseases. Conclusion. Isolated pituitary stalk lesions could be a signal of intracranial germ cell tumors, especially coexisting with diabetes insipidus, hypopituitarism, and a worse response to glucocorticoid therapy. Negative results of tumor markers and pathology could not exclude the diagnosis. Chemoradiotherapy is an effective therapy, leaving mild-t-moderate hypothalamus-pituitary dysfunction. This rare neuroimaging feature may be used as a factor to predict long-term neuroendocrine outcomes.http://dx.doi.org/10.1155/2022/9213220 |
| spellingShingle | Han Chen Ming Ni Yun Xu Li-Yong Zhong Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review International Journal of Endocrinology |
| title | Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review |
| title_full | Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review |
| title_fullStr | Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review |
| title_full_unstemmed | Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review |
| title_short | Pituitary Stalk Germ Cell Tumors: Retrospective Case Series and Literature Review |
| title_sort | pituitary stalk germ cell tumors retrospective case series and literature review |
| url | http://dx.doi.org/10.1155/2022/9213220 |
| work_keys_str_mv | AT hanchen pituitarystalkgermcelltumorsretrospectivecaseseriesandliteraturereview AT mingni pituitarystalkgermcelltumorsretrospectivecaseseriesandliteraturereview AT yunxu pituitarystalkgermcelltumorsretrospectivecaseseriesandliteraturereview AT liyongzhong pituitarystalkgermcelltumorsretrospectivecaseseriesandliteraturereview |