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Endocrine Abstracts (2022) 81 OC14.2 | DOI: 10.1530/endoabs.81.OC14.2

1Hospital Universitário Evangélico Mackenzie, Brazil; 2Evangelical Mackenzie Faculty of Parana, Brazil


Introduction: Low-grade pituitary gliomas are extremely rare neoplasms, originating from the pituicytes of the posterior pituitary or infundibulum. The incidence of these tumors increases with age and peaks in the seventh decade of life. Gliomas are primary brain tumors of the supporting glial cells of the central nervous system, which derive from neuroglial stem cells or progenitor cells. They are responsible for nearly 30% of all primary brain tumors and 80% of all malignant tumors, as well as the majority of deaths from primary brain tumors. The clinical manifestation is mainly through visual impairment, due to optic nerve compression, headache, and pituitary deficits.

Case report: A 16-year-old female patient presented with left peripheral facial paralysis, with no change in the imaging tests, with spontaneous improvement. Evolved with progressive headache, severe nasal congestion, bilateral visual acuity alteration, and right peripheral facial paralysis, associated with findings of a tumor in the sellar topography, dilatation of the supratentorial ventricular system, and diffuse meningeal impregnation, suggestive of the spread of the pathology. She underwent a ventriculoperitoneal shunt and subsequent transsphenoidal excision of the mass (4.9 × 2.6 × 2.5 cm) which was successfully performed. Anatomopathological analysis showed a round cell neoplasm with fibrillar background and low-grade hyalinized vessels, suggestive of glial neoplasm. In the early postoperative period, developed diabetes insipidus, treated with desmopressin acetate nasal spray 0.1 mg/ml twice a day, and hypothalamic obesity. In the outpatient follow-up, a diagnosis of panhypopituitarism was made, consisting of hypogonadotropic hypogonadism, central adrenal insufficiency, and central hypothyroidism, and replacement of estradiol valerate 2 mg + levonorgestrel 0.25 mg, hydrocortisone 17.5 mg, and levothyroxine 123 mg/day was initiated. The patient remains under outpatient follow-up, in good general condition, asymptomatic, and with good control of complications.

Conclusion: Although pituitary tumors are the most commonly found intracranial neoplasms, the low-grade pituitary glioma presented by the patient is an extremely rare pathology. However, as it has the potential to manifest in several forms, which go far beyond those described in the literature, it should always be considered in the differential diagnosis of pituitary neoplasms, given its potential for complications and the need for early radical treatment aimed at healing the patient.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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