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Endocrine Abstracts (2015) 39 OC6.10 | DOI: 10.1530/endoabs.39.OC6.10

BSPED2015 ORAL COMMUNICATIONS Oral Communications 6 (10 abstracts)

Neuroradiological features in a cohort of 53 children with Thickened Pituitary Stalk (TPS) and/or idiopathic central diabetes insipidus

Manuela Cerbone 1 , Ash Ederies 2 , Laura Losa 1 , Carolina Moreno 1 & Helen A Spoudeas 1


1London Centre for Paediatric Endocrinology, Neuroendocrine Division, University College and Great Ormond Street Hospitals, London, UK; 2Neuroradiology Department, Great Ormond Street Hospital, London, UK.


Introduction: Children with TPS and/or ICDI represent a diagnostic and management conundrum. Agreed radiological criteria for TPS are lacking.

Aims: To longitudinally characterize the neuroradiological features of children presenting with TPS and/or ICDI due to different aetiologies (oncological, inflammatory, idiopathic).

Methods: We searched the terms ‘thickened pituitary stalk’ or ‘idiopathic diabetes insipidus’ in electronic radiology at our centre over the last 30 years. 53 patients presenting with ICDI (38) TPS (10) or TPS+ICDI (5) were identified and their MRI scans reviewed.

Results: Median age at diagnosis was 9.02 (6.47) for TPS, 8.29 (8.13) for CDI, 3.84 (6.98) TPS+ICDI. During the follow-up (TPS 2.45 (3.14), ICDI 5.12 (5.31), ICDI+TPS 3.11 (3.89) years) 18 ICDI patients (47%) evolved to include TPS (3 with germinoma, 8 with LCH, 7 Idiopathic), whereas only 1 patient with TPS (LCH) developed CDI. All patients with a final diagnosis of LCH had TPS at presentation. Top and middle stalk sizes were bigger in LCH patients compared to germinomas and idiopathic groups. Idiopathic patients presented with any pattern of thickening, whereas germinomas presented with upper and middle thickening only and LCH with uniform, upper and middle thickening. 73.3% of LCH patients presented with small anterior pituitary, despite similar prevalence of anterior pituitary deficits at presentation compared with germinomas and idiopathic cases. 85.7% of germinomas and 69.6% of idiopathic cases had absent posterior pituitary at presentation.

Conclusions: Half of the patients with ICDI will develop TPS during a median 5 years follow-up. LCH patients present with bigger stalk sizes and higher prevalence of pituitary hypoplasia, whereas germinomas and idiopathic patients have more frequently absent posterior pituitary. Pattern of thickening differs across the groups with germinomas presenting more frequently with upper stalk thickening, LCH with upper and middle thickening and idiopathic with any pattern of thickening.

Volume 39

43rd Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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