Endocrinol Metab.  2011 Mar;26(1):67-71. 10.3803/EnM.2011.26.1.67.

A Case of Ectopic Neurohypophysis Presenting with Hypogonadism

• Baek IW
• Kim JH
• Lee GJ
• Lee KE
• Lee HL
• Lee HW
• Kim NY
• Ihn YK
• Ko SH
• Lee SH
• Han JH

• KMID: 2169127
• DOI: http://doi.org/10.3803/EnM.2011.26.1.67

Abstract

Pituitary stalk interruption and ectopic neurohypophysis seen on magnetic resonance Imaging (MRI) are often associated with either isolated growth hormone (GH) deficiency or combined anterior pituitary hormone deficiency, but their pathogenesis is not clear and the clinical data regarding these anatomical defect is limited. We experienced a 23-year-old male with the absence of secondary sexual characteristics and this was accompanied with pituitary stalk dysgenesis and ectopic neurohypophysis. He received growth hormone for a year when he was 12 years old due to his short stature. Sella MRI showed no visible pituitary stalk with minimal high signal change, suggesting ectopic neurohypophysis. The combined pituitary stimulation test revealed blunted responses of growth hormone, follicle stimulating hormone and luteinizing hormone. For the hypogonadotropic hypogonadism, the patient was given testosterone intramuscularly and he gradually developed secondary sexual characteristics. We concluded that the hypogonadism and growth hormone deficiency in this patient was caused by hypopituitarism due to pituitary stalk dysgenesis and ecopic nuerohypophysis.

Keyword

Hypopituitarism; Hypogonadism; Ectopic neurohypophysis

MeSH Terms

Follicle Stimulating Hormone
Growth Hormone
Humans
Hypogonadism
Hypopituitarism
Luteinizing Hormone
Magnetic Resonance Imaging
Male
Pituitary Gland
Pituitary Gland, Posterior
Testosterone
Young Adult
Follicle Stimulating Hormone
Growth Hormone
Luteinizing Hormone
Testosterone

Figure

• 

  Fig. 1 Ultrasonography showed undescended testis in both side. Right testis (A) was detected at superior portion of scrotal sac and the size was 1.33 × 0.82 cm. Left testis (B) was detected at inguinal canal and the size was 1.13 × 0.72 cm.

• 

  Fig. 2 Sagittal (A) and coronal (B) T1 weighted images of sella MRI show a small high signal change suggesting ectopic posterior pituitary gland (arrows). No visible normal pituitary stalk was noted.

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