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Chung, Hong, Cho, Chung, and Chung: A Case of Slipped Capital Femoral Epiphysis in Association with Panhypopituitarism after Treatment of Craniopharyngioma
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2008; 23(3): 193-198.

Published online: 20 June 2008

DOI: https://doi.org/10.3803/jkes.2008.23.3.193

A Case of Slipped Capital Femoral Epiphysis in Association with Panhypopituitarism after Treatment of Craniopharyngioma

Jin Ook Chung, Se In Hong, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung

Department of Internal Medicine, Chonnam National University Medical School, Korea.

Received 9 January 2008       Accepted 23 April 2008

Copyright © 2008 Korean Endocrine Society

Abstract

Craniopharyngioma accounts for 2~5% of all primary intracranial neoplasms. It may present with a variety of manifestations including neurological, visual, and/or hypothalamic-pituitary dysfunction. Treatment options include radical surgery or radiotherapy, or a combination of these modalities. Craniopharyngioma ablation results in anterior and/or posterior pituitary hormone deficits. Slipped capital femoral epiphysis (SCFE), in which the femoral head slips downward and backward on the femoral neck at the epiphyseal plate, most commonly occurs during the rapid growth phase of puberty. Its actual cause is unknown, but the clinical association between SCFE and endocrine disorders is well known. We report a case of an adult male patient who developed SCFE in association with panhypopituitarism after treatment of a craniopharyngioma.

Keywords: craniopharyngioma, hypopituitarism, SCFE

Figures and Tables

Figure 1
Frontal view of external genitalia of the patient showed hypoplastic genitalia with no pubic hair. Penis was 3 cm in length. The volume of right testis was 2 cc, and that of left was 1 cc.
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Figure 2
A. Preoperative both hip A-P view showed downward and posterior slipping of the left femoral epiphysis. B. Postoperative both hip A-P view showed internal fixation with cannulated screw of both femoral epiphysis.
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Figure 3
Hand X-ray showed bone age corresponding with 12 years. All carpal bones were shown. The epiphyseal growth plates of metacarpal, phalangeal, distal ulnar and radial bone were not closed.
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Figure 4
A. Preoperative sagittal T1 - weighted sellar MRI showed 1.8 cm sized well circumscribed mass with suprasellar extension. B. 12 years later, sagittal T1 - weighted sellar MRI showed empty sella with no remnant mass.
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Table 1
Water deprivation test & pitressin stimulation test
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ADH, antidiuretic hormone; S-Osm, serum osmolarity U-Osm, urine osmolarity.

Table 2
Anterior pituitary hormone stimulation test before tumor resection at the age of 17
jkes-23-193-i002

FSH, follicle-stimulating hormone; GH, growth hormone; LH, luteinizing hormone; TSH, thyroid stimulating hormone.

Table 3
Combined anterior pituitary hormone stimulation test* at the age of 29
jkes-23-193-i003

*After regular insulin 5 u, TRH 400 µg, LHRH 100 µg. †IGF-1 (age-adjusted normal range: 114~492).

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