A rare case of SIAD in unique association with the rare lesion of a pituicytoma

Sonia Kaniuka-Jakubowska; Maria Maksymowicz; Grzegorz Zielinski; Małgorzata Zdrojewska; Nicole Kaźmierczak; John Wass; Federico Roncaroli; Renata Świątkowska-Stodulska

doi:10.1530/endoabs.99.EP719

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Endocrine Abstracts (2024) 99 EP719 | DOI: 10.1530/endoabs.99.EP719

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

A rare case of SIAD in unique association with the rare lesion of a pituicytoma

Sonia Kaniuka-Jakubowska ¹ , Maria Maksymowicz ² , Grzegorz Zielinski ³ , Małgorzata Zdrojewska ¹ , Nicole Kaźmierczak ¹ , John Wass ⁴ , Federico Roncaroli ⁵ & Renata Świątkowska-Stodulska ¹

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¹Facult, of Medicine, Medical University of Gdansky Department of Endocrinology and Internal Medicine, Gdansk, Poland; ²Maria Sklodowska-Curie National Research Institute of Oncology Department of Cancer Pathomorphology Warsaw, Poland; ³Militar, Institute of Medicine, Department of Neurosurgery Warsaw, Poland; ⁴Oxford University Hospitals NHS Foundation Trust, Department of Endocrinology at the Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, United Kingdom; ⁵Facult, of Biology Medicine and Health, University of Manchester, Division of Neuroscience, Manchester, United Kingdom

Introduction: AVP secretion disturbances in pituitary lesions usuall, present as AVP deficienc, due to compression of the posterior pituitary lobe. Excessive secretion of AVP (syndrome of inappropriate antidiuresis) (SIAD) is ver, uncommon in patients with pituitary tumor. A few cases of non-functionating adenoma, prolactinoma, and even pituitary apoplex, were described to present with SIAD. Pituicytoma is a rare tumor of the neurohypophysis. The, usuall, present with visual defects, hypopituitarism, headache, and fatigue. Rarel, the, are associated with Cushing’s disease or acromegaly. We present a patient with pituicytoma with SIAD.

Case presentation: A 45-year-old female was admitted with hyponatremia. Low sodium levels were first noted six months before knee replacement surgery. There was no hyponatremia 2 years before, in random check. The patient onl, complained with muscle cramps. The Laboratory results were compatible with SIAD: hyponatremia, plasma hypoosmolality urine hyperosmolarity and increased urinar, sodium excretion, without an, features of adrenal, thyroid or renal disturbances. She underwent detailed screening for malignanc, and the onl, finding was pituitary mass. Pituitary MRI revealed a 6x9x13mm lesion in the left-lateral part of the pituitary with involvement of the pituitary stalk. The patient refused fluid restriction and insisted on surgical treatment. After surgery she presented with AVP deficienc, on graduall, decreasing doses of desmopressin. Histopathological results revealed pituicytoma.

Conclusion: To our knowledge, this is the first documented case of pituicytoma presenting with SIAD. SIAD associated with pituitary lesions is ver, uncommon. A common mechanism causing AVP oversecretion irrespective of the type of lesion is possible including AVP secretion b, the pituitary mass.