A Case of Lymphocytic Hypophysitis Occurred in The Third Trimester of Pregnancy

Park, Man Chul; Youn, Moon Hee; Lee, Won Ki

Abstract

Lymphocytic hypophysitis is a rare but important cause of pituitary hypofunction which predominantly affects young women in the peripartum period. It is believed to be an autoimmune disorder with an association with other autoimmune disorders. Clinically, it presents most frequently with symptoms and signs attributable to pituitary hypofunction, headache, visual disturbance and amenorrhea. It is difficult to distinguish lymphocytic hypophysitis from a pituitary adenoma on preoperative imaging. So the diagnosis must be confirmed pathologically. The frozen section must be done for saving the risk of permanent hypopituitarism that would have attended a more radical debulking procedure. If lymphocytic hypophysitis is confirmed by frozen section, extensive surgical debulking may not be necessary. A 31-year-old woman presented during the third trimester of pregnancy in July of 2003 with headache, vomiting and gradually progressive bilateral visual loss. There was a large 8 shaped homogeneous sellar mass on MR images before delivery. The subtotal excision of tumor was done via transsphenoidal surgery three weeks after cesarean delivery. Visual field testing revealed marked resolution of her visual field defects in both eyes. We report a case of lymphocytic hypophysitis occurred in the third trimester of pregnancy with a brief review of literatures.