Long Term Sustaining Enhanced Infundibulum-hypophysitis: A Case Report

Abstract

Introduction: Hypophysitis is a non-infectious chronic inflammation. Lymphocytic hypophysitis which is the most frequent adult hypophysitis naturally remit within 2 years.

Case report: The patient is female. She has had a bilateral occasional headache since her twenties. Her polyuria and thirsty started at 32 years old. She was diagnosed with central diabetes insipidus and desmopressin was started at 33 years old. Magnetic resonance imaging (MRI) showed swelling of the pituitary stalk and 3rd ventricle floor, which were homogeneously enhanced. Brain MRI showed stable disease until 9 years after symptom onset. At 10 years since symptom onset, the decrease of the enhanced lesion was observed.

Discussion: Because of self-limiting benign natural history, the biopsy is generally not applied for the patients under the diagnosis of lymphocytic hypophysitis. Our case showed the problem of the watch and scan strategy.

Conclusion: We reported the case of infundibulum-hypophysitis those enhanced lesions sustained for 9 years. This case report demonstrated the problem of the watch and scan strategy.