Localised Langerhans cell histiocytosis of the hypothalamic-pituitary region: case report and literature review

Hormones (Athens). 2018 Mar;17(1):119-125. doi: 10.1007/s42000-018-0024-6. Epub 2018 Apr 16.

Abstract

Introduction: Langerhans cell histiocytosis (LCH) localised in the hypothalamic-pituitary region (HPR) is very rare, especially in adults. Diabetes insipidus (DI) is considered to be a hallmark of HPR LCH, while anterior pituitary abnormalities are usually seen as consequences of surgery, radiotherapy or chemotherapy.

Case description: We present a patient with localised HPR LCH with dominant anterior pituitary dysfunction and tumour mass effects but without DI. Seven years after surgery and local radiotherapy, she is stable. Control MRI shows no residual tumour growth and thorough physical examination is still without any signs of disease spread.

Conclusions: Anterior pituitary deficiency can appear without DI and not only as a consequence of LCH treatment. All patients with LCH should be screened for this endocrine abnormality so that appropriate substitution therapy may be provided.

Keywords: Anterior pituitary deficiency; Hypothalamic-pituitary region; Langerhans cell histiocytosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Female
  • Histiocytosis, Langerhans-Cell / diagnosis*
  • Histiocytosis, Langerhans-Cell / pathology
  • Histiocytosis, Langerhans-Cell / surgery
  • Humans
  • Hypothalamic Diseases / diagnosis*
  • Hypothalamic Diseases / pathology
  • Hypothalamic Diseases / surgery
  • Magnetic Resonance Imaging
  • Pituitary Diseases / diagnosis*
  • Pituitary Diseases / pathology
  • Pituitary Diseases / surgery
  • Treatment Outcome