A Case of Rathke’s Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus

Masahiro Asakawa; Rina Chin; Yoshihiro Niitsu; Tetsuo Sekine; Arisa Niwa; Atsuko Miyake; Naoko Inoshita; Mitsunobu Kawamura; Yoshihiro Ogawa; Yukio Hirata

doi:10.1155/2014/693294

Case Reports in Endocrinology (Jan 2014)

A Case of Rathke’s Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus

Masahiro Asakawa,
Rina Chin,
Yoshihiro Niitsu,
Tetsuo Sekine,
Arisa Niwa,
Atsuko Miyake,
Naoko Inoshita,
Mitsunobu Kawamura,
Yoshihiro Ogawa,
Yukio Hirata

Affiliations

Masahiro Asakawa: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
Rina Chin: Department of Endocrinology and Metabolism, Tokyo Kyosai Hospital, 2-3-8, Nakameguro, Meguro-ku, Tokyo 153-0061, Japan
Yoshihiro Niitsu: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
Tetsuo Sekine: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
Arisa Niwa: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
Atsuko Miyake: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
Naoko Inoshita: Department of Pathology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo 105-0001, Japan
Mitsunobu Kawamura: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan
Yoshihiro Ogawa: Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University Hospital, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Yukio Hirata: Institute of Biochemical Research and Innovation Hospital, 2-2 Minatoshima-Minamicho, Chuo-ku, Kobe, Hyogo 650-0047, Japan

DOI: https://doi.org/10.1155/2014/693294
Journal volume & issue: Vol. 2014

Abstract

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A 73-year-old woman admitted to our hospital because of headache, poor appetite, malaise, weight loss, and vomiting was found to have central adrenal insufficiency and thyrotoxicosis due to silent thyroiditis. Polyuria developed after replacement with glucocorticoid (masked diabetes insipidus), which was controlled with nasal administration of desmopressin. Magnetic resonance imaging of the brain showed a large cystic pituitary mass (18 × 18 × 12 mm) extending suprasellarly to the optic chiasm. Transsphenoidal surgery revealed that the pituitary tumor was Rathke’s cleft cyst. Following surgery, replacement with neither glucocorticoid nor desmopressin was needed any more. Therefore, it is suggested that Rathke’s cleft cyst is responsible for the masked diabetes insipidus and the central insufficiency. Furthermore, it is speculated that thyrotoxicosis with painless thyroiditis might induce changes from subclinical adrenal insufficiency to transiently overt insufficiency.

Published in Case Reports in Endocrinology

ISSN: 2090-6501 (Print); 2090-651X (Online)
Publisher: Wiley
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://onlinelibrary.wiley.com/journal/7520

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