Diseases of the pituitary stalk

Hana Charfi; Salah Dhoha Ben; Mouna Elleuch; Yesmine Elloumi; Fatma Mnif; Nadia Charfi; Mouna Mnif; Kacem Akid Faten Haj; Mohamed Abid; Majdoub Nabila Rekik

doi:10.1530/endoabs.99.EP471

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Endocrine Abstracts (2024) 99 EP471 | DOI: 10.1530/endoabs.99.EP471

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Diseases of the pituitary stalk

Hana Charfi ¹ , Dhoha Ben Salah ¹ , Mouna Elleuch ¹ , Yesmine Elloumi ¹ , Fatma Mnif ¹ , Nadia Charfi ¹ , Mouna Mnif ¹ , Faten Haj Kacem Akid ¹ , Mohamed Abid ¹ & Nabila Rekik Majdoub ¹

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¹Hedi Chaker Hospital, Endocrinology-Diabetology Departement, Sfax, Tunisia

Introduction: The pituitary stalk (PS) can be the target of various congenital or acquired pathologies. These conditions are increasingly encountered with the advent and development of magnetic resonance imaging (MRI). Clinically, PS pathology is often revealed by the occurrence of diabetes insipidus. However, other clinical manifestations related to hypothalamo-hypophysial involvement may also be variably associated.

Objective: To identify the circumstances of discovery, clinical features, hormonal aspects, and radiological findings related to pituitary stalk pathology.

Materials and Methods: A retrospective study of 34 patients with pituitary stalk anomalies, hospitalized at the Endocrinology Department of Hedi Chaker University Hospital in Sfax over a 24-year period.

Results: The average age of our patients at the time of diagnosis was 28 years. A male predominance was noted with a sex ratio of 1.2. The most common circumstances of discovery were polyuro-polydipsic syndrome and growth delay in 41% of cases each. Anterior pituitary insufficiency was present in 73% of patients. Diabetes insipidus was diagnosed in 52% of cases. Pituitary stalk hypertrophy, described in 44% of cases, was secondary to granulomatosis (40%), metastatic origin (26.66%), lymphocytic hypophysitis (13.33%), and idiopathic (20%). Pituitary stalk interruption, present in 56% of patients, was post-surgical, post-traumatic, and idiopathic in 21%, 10.5%, and 68.5%, respectively.

Conclusion: The spectrum of pituitary stalk pathologies is extensive, posing a diagnostic challenge. Knowledge of the main differential diagnoses is crucial for better management.