ECE2021 Eposter Presentations Pituitary and Neuroendocrinology (32 abstracts)
1National Institute of Nutrition, Endocrinology Diabetology, Tunis, Tunisia; 2National Institute of Neurology, Radiology, Tunis, Tunisia
Introduction
Rathke Cleft Cysts (RCC) are common benign cystic lesions in the sellar region. These cysts are often small, intrapituitary and asymptomatic. Voluminous forms are rare and can be symptomatic by compressing the adjacent structures. We report the case of pituitary insufficiency related to RCC.
Observation
A male patient aged 49 years old, diagnosed with type 2 diabetes since 8 years treated with metformin and glimiperide, was addressed to the endocrinology department for additional exploration of frequent hypoglycemic episodes occurring despite stopping glimepiride. The patient was also presented with hormonal findings of central hypothyroidism. Patient complained of headache and erectile dysfunction. No Polyuria-polydipsia syndrome was found. Exploration of the other pituitary axes concluded to central hypogonadism and central adrenal insufficiency. The patient was treated with hydrocortisone and levothyroxine. The pituitary MRI showed a posterior intrasellar expansive process, extended to the suprasellar space and compressing the optic chiasma. Fundus and visual field examination were normal. The patient underwent endoscopic endonasal transsphenoidal surgery. Pathological examination was in favor of RCC. After surgery, hypopituitarism was persistent.
Discussion
Symptomatic RCC represent 5 to 15% of operated sellar region tumors. This pathology is often diagnosed in children. Our case is particular because of the appearance of symptoms in adulthood and the atypical radiological presentation, mimicking a tumor of the post pituitary gland.