Primary CNS lymphoma with bilateral symmetric hypothalamic lesions presenting with panhypopituitarism and diabetes insipidus.

Details

Serval ID
serval:BIB_CB2B295589B9
Type
Article: article from journal or magazin.
Collection
Publications
Title
Primary CNS lymphoma with bilateral symmetric hypothalamic lesions presenting with panhypopituitarism and diabetes insipidus.
Journal
Pituitary
Author(s)
Layden B.T., Dubner S., Toft D.J., Kopp P., Grimm S., Molitch M.E.
ISSN
1573-7403 (Electronic)
ISSN-L
1386-341X
Publication state
Published
Issued date
06/2011
Peer-reviewed
Oui
Volume
14
Number
2
Pages
194-197
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
We present an unusual case of primary central nervous system (CNS) lymphoma presenting with bilateral symmetric hypothalamic lesions causing diabetes insipidus and hypopituitarism. A 50-year-old male presented initially with mental status changes, polyuria and polydipsia. The patient was determined to have diabetes insipidus (DI) and significant anterior pituitary deficiencies resulting in symptomatic pleural and pericardial effusions. Brain MRI with contrast demonstrated bilateral enhancement of his hypothalamus extending to the optic tract. The extensive diagnostic workup that ensued on his initial presentation was non-diagnostic as he had no obvious site of involvement that was easily accessible to biopsy. With close follow-up, the patient had rapid radiographic progression of his disease to his cerebral hemispheres. He therefore underwent brain biopsy and was diagnosed with primary CNS large B cell lymphoma. Chemotherapy has resulted in disease remission with resolution of MRI findings, but the patient has not had resolution of the hypopituitarism or DI. This case highlights the unique diagnostic challenge of patients with isolated hypothalamic lesions.
Keywords
Central Nervous System Neoplasms/complications, Central Nervous System Neoplasms/diagnosis, Central Nervous System Neoplasms/diagnostic imaging, Diabetes Insipidus, Neurogenic/diagnosis, Diabetes Insipidus, Neurogenic/diagnostic imaging, Diabetes Insipidus, Neurogenic/etiology, Diagnosis, Differential, Humans, Hypopituitarism/diagnosis, Hypopituitarism/diagnostic imaging, Hypopituitarism/etiology, Hypothalamic Neoplasms/complications, Hypothalamic Neoplasms/diagnosis, Hypothalamic Neoplasms/diagnostic imaging, Lymphoma/complications, Lymphoma/diagnosis, Lymphoma/diagnostic imaging, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasms, Multiple Primary/complications, Neoplasms, Multiple Primary/diagnosis, Neoplasms, Multiple Primary/diagnostic imaging, Radiography
Pubmed
Web of science
Create date
28/12/2020 16:44
Last modification date
29/12/2020 7:26
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