A Case of Panhypopituitarism with Normal Height Manifesting the Transection of the Pituitary Stalk and the Formation of the Ectopic and Eutopic Posterior Lobes

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  • IHARA Chihiro
    Second Division, Department of Internal Medicine, Kyoto University Faculty of Medicine
  • SHIMATSU Akira
    Second Division, Department of Internal Medicine, Kyoto University Faculty of Medicine
  • TANOH Tsutomu
    Second Division, Department of Internal Medicine, Kyoto University Faculty of Medicine
  • HARADA Masaki
    Second Division, Department of Internal Medicine, Kyoto University Faculty of Medicine
  • NAKAMURA Tomoyuki
    Second Division, Department of Internal Medicine, Kyoto University Faculty of Medicine
  • IMURA Hiroo
    Second Division, Department of Internal Medicine, Kyoto University Faculty of Medicine

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  • MRIにより下垂体茎断裂と正所性及び異所性後葉像を認め, 未治療で正常身長に達した汎下垂体機能低下症の1成人例

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A 33-year-old man with hypopituitarism is documented. He was born at breech presentation without asphyxia. He was the shortest in his class throughout his school days. He kept slowly growing and reached 172.8cm at the age of 33. He was devoid of secondary sexual characteristics. Endocrinological studies showed panhypopituitarism with elevated levels of plasma TSH (15.0μU/ml). TRH administration resulted in a marked increase in plasma TSH. Posterior pituitary function was normal. MR imaging showed transection of the pituitary stalk and the presence of ectopic and eutopic posterior lobes. The replacement of corticosteroid was initiated, and exaggerated response of TSH to TRH disappeared. Delayed bone maturation due to hypogonadism and hypothyroidism was one of the reasons why he had normal height without GH therapy. The significance of his peculiar MRI findings remains to be determined.

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