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Ectopic posterior pituitary

Case Detail

Anatomy: Brain-Spine
Borders
Heather Borders, MD
Diagnostic Category: Developmental or Congenital
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: MRI
Activities:
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History

Growth hormone deficiency


Case Images


Diagnosis

Ectopic posterior pituitary

Findings

Ectopic posterior pituitary bright spot located along the proximal infundibulum. Thinning of the infundibulum distal to the ectopic lobe. Relatively normal appearing anterior pituitary.

Discussion

Disorder of midline prosencephalon development. The anterior pituitary develops from rathkes pouch while the posterior pituitary develops from the diencephalon and should remain in contact with the infundibulum. Defective migration of the posterior lobe may result in an ectopic gland.

The ectopic posterior lobe is often associated with multiple hormone deficiencies. ADH and oxytocin are transported to the neurohypophysis by neurosecretory cells along the infundibular stalk while hypothalamic releasing hormones are transported to the adenohypophysis via vessels along the infundibulum. There is often abnormality of the anterior gland hormones related to dysfunction of the infundibulum.

Associated midline anomalies such as holoprosencephaly are common.

Disorder usually becomes evident due to growth failure. Patients with peak growth hormone levels less than 3g/L are more likely to have an abnormal MRI.

Research suggests patients with a visible infundibulum after contrast have less severe hormonal problems and tend to have isolated growth hormone deficiency.

Reference

StatDx. Pituitary anomalies. Susan Blaser.
The Journal of Clinical Endocrinology & Metabolism Vol. 84, No. 7 2408-2413



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