Pituitary stalk interruption syndrome presenting in a euthyroid adult with short stature

Abstract

Pituitary stalk interruption syndrome (PSIS) is a distinct and rare clinical entity responsible for congenital hypopituitarism resulting in deficiency of pituitary hormones with deficiency of the growth hormone (100%) and gonadotropins (97.2%) being its most common presentation at the time of hospital encounter (Wang et al., 2015). Isolated sparing of thyroid-stimulating hormone (TSH) with deficiency of the remaining anterior pituitary hormones may be present in PSIS, as is true in our case. Therefore, it should be kept in mind at the time of examination in suspected cases of PSIS.

Keywords: MRI.

Fig. 1

T1 sagittal image without contrast, showing hyperintense focus posterior to optic chiasma (yellow arrow). FLP, foot left posterior; HRA, head right anterior; L, left; PR, posterior right.

Fig. 2

Coronal T2 image showing nonvisualization of the pituitary stalk. FPL, foot posterior towards left; HAR, head anterior towards right; LP, left posterior; RAF, right anterior towards front.

Fig. 3

Sagittal T1 postcontrast image showing enhancement of the hyperintense focus seen on plain T1 image behind optic chiasma representing the ectopic posterior pituitary gland (yellow arrow). ALF, anterior left front; FLP, foot left posterior; HRA, head right anterior; PR, posterior right.