Ectopic posterior pituitary
15 day old neonate presenting with micropenis, hypoglycaemia, micrognathia, flat LHRH test, abnormal synacthen test suggestive of hypoadrenalism ?hypopituitarism.
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There is no normal anterior pituitary gland tissue identified. There is a 0.3 cm T1W hyperintense nodule in the hypothalamus in keeping with a heterotopic posterior pituitary lobe. No other structural brain abnormality is identified in the remainder of the study.
An ectopic posterior pituitary reflects a disruption of normal embryogenesis and is one of the more common causes of pituitary dwarfism. Although it can be an isolated abnormality, numerous other congenital central nervous system malformations have been identified.
No treatment is required for the ectopic pituitary per se, but rather for the frequently associated growth hormone deficiency, or less frequently panhypopituitarism. Growth hormone replacement is available in selected patients and can improve adult height.