International Journal of Radiology and Imaging Techniques Int J Radiol Imaging Technol 10.23937/2572-3235 2572-3235 ClinMed International Library Wilmington, USA 10.23937 Late Discovery of Pituitary Stalk Interruption Saida J 10.23937/2572-3235.1510081 MR imaging showed a small-sized anterior pituitary gland pituitary (height mesaured 3 mm) with interrupted pituitary stalk (Figure 1) and an absent posterior pituitary gland (Figure 2). CASE REPORT 7 2 OPEN ACCESS 10.23937/2572-3235.1510081 Late Discovery of Pituitary Stalk Interruption Jerbi Saida Department of Radiology, Taher Sfar Hospital, Tunisia Ben Fatma Abderraouf Department of Radiology, Taher Sfar Hospital, Tunisia Souissi Marouen Department of Radiology, Taher Sfar Hospital, Tunisia Ikbel Ammar Department of Radiology, Taher Sfar Hospital, Tunisia Ben Fatma Abderraouf
Department of Radiology, Taher Sfar hospital, Mehdia,Tunisia
 26 November 2021 Saida J, Abderraouf BF, Marouen S, Ammar I 2021 Late Discovery of Pituitary Stalk Interruption Int J Radiol Imaging Technol 10.23937/2572-3235.1510081 2021 Saida J, et al. © This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A 25-year-old male patient presented with delayed puberty, short stature.

Hormonal assays showed anterior pituitary insufficiency.

MR imaging showed a small-sized anterior pituitary gland pituitary (height mesaured 3 mm) with interrupted pituitary stalk (Figure 1) and an absent posterior pituitary gland (Figure 2).

• Pituitary stalk interruption syndrome [1,2] is a congenital abnormality of the pituitary gland consisting of the triad of thin or interrupted pituitary stalk, small or absent anterior pituitary gland, and an absent or ectopic posterior pituitary gland. It is characterised by deficiencies in the hormones secreted by the anterior pituitary gland, however mild hyperprolactinaemia may be seen. This is secondary to dopamine being unable to reach the pituitary and inhibit the lactotrophs as there is no pituitary stalk.

• Clinically, it is characterised by delayed puberty, short stature, micropenis, cryptorchidism and visual defects, hypoglycemia.

• MRI is required for the diagnosis and demonstrates:

a) Absent/hypoplastic anterior pituitary gland.

b) Thin or absent infundibulum.

• Ectopic or absent posterior pituitary

• Treatment consists of hormonal replacement.

• Pituitary stalk interruption syndrome is a very rare congenital syndrome, characterised by a classic triad of anterior pituitary hypoplasia or aplasia, ectopic or aplasic posterior pituitary and interrupted pituitary stalk.

a) The pathogenesis of this condition is still unknown.

b) Growth retardation is the most common presentation in older children and adults. Most patients lack sexual development.

Pituitary stalk interruption syndrome.

Craniopharanygioma, Histiocytosis, Pituitary Macroadenomas.

 Postcontrast coronal T1-weighted image shows interrupted proximal pituitary stalk (arrow) and small anterior pituitary measuring 3 mm in height. https://www.clinmedjournals.org/articles/ijrit/ijrit-7-081-001.jpg Sagittal unenhanced T1-weighted image shows the absence of the posterior pituitary. https://www.clinmedjournals.org/articles/ijrit/ijrit-7-081-002.jpg References Gutch M, Kumar S, Razi SM, Saran S, Gupta KK (2014) Pituitary stalk interruption syndrome: Case report of three cases with review of literature. J Pediatr Neurosci 9: 188-191. https://pubmed.ncbi.nlm.nih.gov/25250085/ Gosi SK, Kanduri S, Garla VV (2019) Pituitary stalk interruption syndrome. BMJ Case Rep 12: e230133. https://casereports.bmj.com/content/bmjcr/12/4/e230133.full.pdf