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. 2021 Apr 14;10(8):1692.
doi: 10.3390/jcm10081692.

Diversity of Pathological Conditions Affecting Pituitary Stalk

Łukasz Kluczyński  1 , Aleksandra Gilis-Januszewska  1 , Magdalena Godlewska  1 , Małgorzata Wójcik  2 , Agata Zygmunt-Górska  2 , Jerzy Starzyk  2 , Alicja Hubalewska-Dydejczyk  1
Affiliations

Diversity of Pathological Conditions Affecting Pituitary Stalk

Łukasz Kluczyński et al. J Clin Med. .

Abstract

Pituitary stalk lesions (PSL) are a very rare pathology. The majority of conditions affecting the infundibulum do not present with clinically apparent symptoms, what makes the diagnosis difficult. The recognition might be also complicated by the non-specific and transient characteristics of hormonal insufficiencies. In our study, we retrospectively analysed demographic, biochemical, and clinical long-term data of 60 consecutive, unselected adult patients (34 women and 26 men) with PSL diagnosed in the Department of Endocrinology, Jagiellonian University in Krakow. The diagnosis of PSL were categorized as confirmed, probable, or undetermined in 26, 26 and 8 patients, accordingly. Given the possible aetiology congenital, inflammatory, and neoplastic stalk lesions were diagnosed in 17, 15 and 20 patients, accordingly. In eight cases the underlying pathology remained undetermined. The most common pituitary abnormality was gonadal insufficiency diagnosed in 50.8% of cases. Diabetes insipidus was detected in 23.3% of cases. In 5% of patients the pituitary function recovered partially over time. Stalk lesions were extensively discussed in the context of the current literature. Based on the published data and our own experience a diagnostic algorithm has been proposed to help physicians with the management of patients with this challenging condition.

Keywords: hypophysitis; infundibulum; pituitary; stalk; tumour.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Atrophic infundibulum in pituitary stalk interruption syndrome.
Figure 2
Figure 2
Magnetic resonance imaging of pituitary area in patient with Langerhans histiocytosis.
Figure 3
Figure 3
Radiological improvement in patient with primary hypophysitis. Pituitary magnetic resonance: (A) June 2018. (B) January 2019 [12].
Figure 4
Figure 4
Magnetic resonance imaging in patients with disseminated neuroendocrine tumour and pituitary metastasis.
Figure 5
Figure 5
Proposed diagnostic algorithm in patients with pituitary stalk lesions. Abbreviations: MRI—magnetic resonance imaging, PSL—pituitary stalk lesion, PSIS—pituitary stalk interruption syndrome, SOD—septo-optic dysplasia.
See this image and copyright information in PMC

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