Ectopic posterior pituitary

Case contributed by Dr David Matthews

Presentation

Child reviewed in pediatric endocrine clinic with significant short stature. Growth hormone deficiency, abnormal thyroid function tests and prolactin above normal limits.

Patient Data

Age: 7 years
Gender: Male

MRI Brain

MRI

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.

Pituitary hormones

Diagram

Case Discussion

DDx 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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