Endocrine Abstracts

A 17-year-old girl was referred to Endocrinology Unit by her neurosurgeon. She had complained of severe headache, palpation induced galactorrhoea on left mammary and visual abnormalities for 1–2 months. Her menstrual period was regular. On physical examination a pale face and fatigued appearance was noticed. Biochemical and hormonal analyses are as follows: fasting glucose level was 84 mg/dl, serum sodium level was 140 mmol/l (136–145), serum potassium level was 3.9 mmol/l, FSH level was 9.24 mIU/ml, LH level was 13.26 mIU/ml, oestradiol level was 70 pg/ml, prolactin level was 22.14 ng/dl, cortisol level was 16.13 μg/dl, free T₄ level was 0.9 ng/dl, and TSH level was 2.01 mIU/l. Her urine analysis showed a normal density. The laboratory analyses did not reveal any anterior or posterior pituitary deficiencies or excess. She underwent a pelvic and breast evaluation for palpation induced galactorrhoea which has existed the last 6 months. Her pelvic ultrasonography revealed a 2.5 cm hyperechoic mass on her right paraoverian area. Magnetic resonance (MR) evaluation showed a 3.5×4 cm right adnexial mass. Signal characteristic of mass was suggestive of dermoid cyst. Breast ultrasound revealed a 18×11 mm hypoechoic heterogeneous solid lesion. Histopathologic examination of the breast mass was consistent with fibroadenoma. Pituitary MR revealed a 10.8×6.5×7 mm sellar mass with homogeneous hyperintensity on T1 weight imaging. The mass was localised posteroinferiorly on left pituitary gland. The features of mass was considered to intense cystic adenom or rathke cleft cyst. The coexistence of pituitary cyst, dermoid ovary cyst, and fibrocystic mammary adenoma was seen in the presented case. Patients with cystic lesion in any tissue should be screened for cystic lesions in other compartments of the body and those cystic lesions including solid components should be followed for the functional activation or loss and malign transformation.