Endocrine Abstracts

Introduction: Xanthomatous hypophysitis (XH) is characterized by inflammatory infiltration of the pituitary gland in which lipid laden macrophages predominate. It can be primary (3% of all primary hypophysitis) and secondary arising in the setting of other lesions: craniopharyngioma, Rathke’s cleft cyst (RCC), adenomas (with subclinical apoplexy). It is more common in women and younger people. The clinical presentation is similar to pituitary tumors and may present with headaches, visual disturbances, hypopituitarism, and diabetes insipidus.

Aim: The aim of this study was to analyze a cohort of patients in whom the existence of xantho-granulomatous hypophysitis (XGH) was confirmed pathohistologically (PH): their clinical, biochemical, radiological, etiological and pathohistological characteristics.

Material and methods: The study analyzed retrospectively collected data from electronic medical histories of patients with PH finding of XGH or XH diagnosed from 2015. to 2020. All patients were hospitalized at the Clinic for Endocrinology, Diabetes and Diseases of Metabolism, and the Clinic of Neurosurgery, University Clinical Center of Serbia.

Results: Cohort included three pediatric and nine adult patients, with an average age of 14.6 ± 4.7 and 54.9 ± 14.4 years (8 male and 4 female). Panhypopituitarism was diagnosed in 5 patients, exclusively men. Compression symptoms were present: headache in 8 patients (66%) and neuro-ophthalmic disorders in 4 patients (33%). Pituitary tumor, as a secondary cause, was found in 5 patients, three women and two men. One patient had a xanthomatous form of hypophysitis, others XGH. Cystic form were present in 3 (25%) patients, and solid in the remaining 9 (75%) patients. Primary, isolated forms were found in five cases (41%) while secondary ones were associated with RCC (2 patients, 16%) and pituitary tumors (5 patients, 41%).

Conclusion: In conclusion, we presented and analyzed a group of 12 patients with a rare form of XGH that differs from previously published studies in terms of sex dimorphism, lower prevalence of xanthomatous form and predominance of solid comparing to cystic forms on magnetic resonance imaging findings. Primary forms were, as expected, less frequent than secondary ones.