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Baek, Kim, Lee, Lee, Lee, Lee, Kim, Ihn, Ko, Lee, and Han: A Case of Ectopic Neurohypophysis Presenting with Hypogonadism
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2011; 26(1): 67-71.

Published online: 31 March 2011

DOI: https://doi.org/10.3803/EnM.2011.26.1.67

A Case of Ectopic Neurohypophysis Presenting with Hypogonadism

In Woon Baek, Ji Hyun Kim, Guk Jin Lee, Kyoung-Eun Lee, Hae Lim Lee, Hye Won Lee, Nam Yong Kim, Yon Kwon Ihn, Seung Hyun Ko, Seung Hwan Lee, Je Ho Han

Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.

Corresponding author: Je Ho Han. Department of Medicine/Endocrinology and Metabolism, The Catholic University of Korea, Incheon St. Mary's Hospital, 665-8 Bupyeong-dong, Bupyeong-gu, Incheon 403-720, Korea. Tel: +82-1544-9004, Fax: +82-32-280-5987, hanendo@catholic.ac.kr

Received 15 October 2010       Accepted 25 January 2011

Copyright © 2011 Korean Endocrine Society

Abstract

Pituitary stalk interruption and ectopic neurohypophysis seen on magnetic resonance Imaging (MRI) are often associated with either isolated growth hormone (GH) deficiency or combined anterior pituitary hormone deficiency, but their pathogenesis is not clear and the clinical data regarding these anatomical defect is limited. We experienced a 23-year-old male with the absence of secondary sexual characteristics and this was accompanied with pituitary stalk dysgenesis and ectopic neurohypophysis. He received growth hormone for a year when he was 12 years old due to his short stature. Sella MRI showed no visible pituitary stalk with minimal high signal change, suggesting ectopic neurohypophysis. The combined pituitary stimulation test revealed blunted responses of growth hormone, follicle stimulating hormone and luteinizing hormone. For the hypogonadotropic hypogonadism, the patient was given testosterone intramuscularly and he gradually developed secondary sexual characteristics. We concluded that the hypogonadism and growth hormone deficiency in this patient was caused by hypopituitarism due to pituitary stalk dysgenesis and ecopic nuerohypophysis.

Keywords: Hypopituitarism, Hypogonadism, Ectopic neurohypophysis

Figures and Tables

Fig. 1
Ultrasonography showed undescended testis in both side. Right testis (A) was detected at superior portion of scrotal sac and the size was 1.33 × 0.82 cm. Left testis (B) was detected at inguinal canal and the size was 1.13 × 0.72 cm.
enm-26-67-g001
Fig. 2
Sagittal (A) and coronal (B) T1 weighted images of sella MRI show a small high signal change suggesting ectopic posterior pituitary gland (arrows). No visible normal pituitary stalk was noted.
enm-26-67-g002
Table 1
Results of combined pituitary stimulation test
enm-26-67-i001

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

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