Endocrine Abstracts

Introduction: Ectopic neurohypophysis is a congenital abnormality related to faulty embryogenesis resulting in incomplete caudal extension of the infundibulum. It may present itself with symptoms of growth hormone deficiency or panhypopituitarism and patients require replacement treatment for panhypopituitarism.

Case Presentation: Our female patient was shorter (138 cm) than her peers and did not menstruate at the age of 19 when she first applied to our hospital with this complaint. Her tests were found to be compatible with panhypopituitarism. Her bone age was found to be 15. On pelvic USG, uterus and ovaries were hypoplasic/atrophic. Breast development: Tanner 1-2. Pituitary MRI revealed total loss of stalk and ectopic neurohypophysis. With the diagnosis of pituitary insufficiency, she took prednisone, levothyroxine and growth hormone for 5 years. Oral contraceptive was not started and final height increase was awaited. Her height increased from 138 cm to 165 cm. Oral contraceptive was added later. After two years, breast development and menstrual order were established and significant improvement was seen in bone mineral density.

Conclusion: Ectopic neurohypophysis might show itself with hypopituitarism like in our patient. Replacement of missing hormones is generally required. If the bone age is lower than the chronological age, it was possible to achieve sufficient height growth with GH treatment before starting oral contraceptives.

Key words: Ectopic neurohypophysis, panhypopituitarism, Replacement treatment