Cranial Germinoma-induced Pituitary Stalk Thickening Misdiagnosed as Lymphocytic Hypophysitis：A Case Report and Literature Review
BIAN Fang
WANG Ning
ZHAO Zhen-zhen
CHEN Huan
CUI Wei
GUO Hui
LIU Juan
YAO Xiao-li
Abstract：Objective To investigate the clinical manifestations, methods of diagnosis and treatment of cranial germi-noma-induced pituitary stalk thickening associated with central diabetes insipid, in order to reduce misdiagnosis and mistreatment rates. Methods Clinical data of one cranial germinoma induced pituitary stalk thickening patient misdiagnosed as lymphocytic hypophysitis was retrospectively analyzed, and the related literature was reviewed. Results This patient suffered from polydipsi-a, polyuria and rarefaction of beard and hirci for 3 years, fever for 1 week, and was misdiagnosed as having lymphocytic hypoph-ysitis leading to central diabetes insipidus according to coherence check. However the symptom was not relieved after oral medi-cation of Glucocorticoids for 3 months. Then this patient was diagnosed as having cranial germinoma by endoscopic transsphenoi-dal pituitary stalk biopsy. The patient's germinoma shrank significantly and the condition was improved after 2 courses of chemo-therapy and 1 course of radiotherapy. The patient was given cortical hormone and thyroid hormones after the surgery. The patient suffered from pituitary crisis after discontinuation of cortical hormone and thyroid hormones because of upper respiratory tract in-fection one week before. The patient was in a stable condition after treatment of antibiotics and hormones. Conclusion Cranial germinoma-induced pituitary stalk thickening may be confirmed with pathology based on information such as age, clinical situa-tion, laboratory examination, imaging data for the benifit of early diagnosis, treatment, and prognosis.
Keywords：GerminomaNervous system neoplasmDiagnostic errorPituitary disease
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 52-56 )