Authors
David Sanchis-Pascual, Rosa Cámara Gómez, Pilar Morillas-Amat, Samuel Romero Domínguez, Joan Carreres-Polo, Darío Lara-Gálvez, Lucía Cano-Jiménez, Juan Díaz Nohales, Juan Francisco Merino-Torres
Published in
Endocrinologia, diabetes y nutricion. Volume 73. Issue 7. Pages 501798.
Abstract
Primary central nervous system lymphoma (PCNSL) involving the hypothalamic-pituitary axis is a rare condition and may present with nonspecific neurologic and endocrine signs, often mimicking more common sellar lesions. We report the case of a 59-year-old woman admitted with subacute behavioral changes, cognitive decline, and polyuria. Magnetic resonance imaging revealed a pituitary-infundibular mass with suprasellar extension and marked bifrontal edema. Endocrine evaluation demonstrated panhypopituitarism and arginine vasopressin deficiency. The clinical course was complicated by severe dysnatremias requiring intensive care management and hormonal replacement. Histopathologic analysis of a transsphenoidal biopsy confirmed diffuse large B-cell lymphoma, with no systemic disease on PET-CT or bone marrow evaluation. The patient was treated with the MATRix chemotherapy regimen followed by autologous stem cell transplantation, achieving sustained complete remission at 3.5 years. Persistent hypogonadotropic hypogonadism remained as a sequelae. This case underscores the diagnostic challenges of sellar involvement by PCNSL and highlights the importance of including lymphoma in the differential diagnosis of hypothalamic-pituitary masses. Acute pituitary failure with severe electrolyte disturbances may precede oncologic diagnosis, and early multidisciplinary management combined with aggressive therapy can result in long-term remission.
PMID:
42744529
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 4
- Comments 0