Endocrine Abstracts

Introduction: Morgagni-Stewart-Morel syndrome is a disorder defined by the presence of internal frontal hyperostosis, variably associated with metabolic disorders, endocrine and neuropsychiatric disorders. Hyperostosis frontalis interna (HFI) is a morphological change of the frontal bone like a single or multiple bilateral nodules on the inner lamina, characteristically sparing the diploë and the midline calvaria.

Case presentation: We present a 61-years old women with hypertension and diabetes mellitus (with oral antidiabetic therapy), obesity, osteoporosis; also the patient was operated in 2005 for a multinodular goiter (total thyroidectomy), treated with L-thyroxin 100 μg per day. She was referred to our department for severe frontal headache which she had suffered for several years, with gradually worsened, failing to respond to nonsteroidal anti-inflammatory drugs in last six months and a history of psychotic disorders. MRI demonstrated the internal hyperostosis frontalis with compression of the cerebral cortex and a small image in the pituitary gland, which is now under observation.

Conclusions: The clinical features of this syndrome was according to those described in the literature. Metabolic and endocrine disorders should not be interpreted as isolated pathology, but as possible pathogenetic factors. We underline the essential role of MRI in detecting the disease correlated with intense headache. The neurological symptoms and psychiatric symptoms were correlated with the severity of internal frontal hyperostosis and cortical atrophy.