Presentation
Child reviewed in paediatric endocrine clinic with significant short stature. Growth hormone deficiency, abnormal thyroid function tests and prolactin above normal limits.
Patient Data
Absence of the normal intra-sellar T1 bright posterior pituitary gland, with a rounded 4 mm T1 bright structure at the floor of the third ventricle (median eminence) in keeping with an ectopic posterior pituitary gland. Anterior pituitary tissue is seen along the floor of the sella.
Attribution:
Image unaltered from Wikimedia:
Source: https://commons.wikimedia.org/wiki/File:1810_Major_Pituitary_Hormones.jpg
License: This file is licensed under the Creative Commons Attribution 3.0 Unported license.
Case Discussion
The differential diagnosis is of a small lipoma.
Hormone deficiencies arise because of incomplete downward extension of the infundibulum. Anterior pituitary hormones normally circulate through the hypophyseal portal circulation. When this is deficient/incomplete, they depend on general circulation, which is less effective.
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