Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus
Joint Authors
Gordon, Murray B.
Gordon, Michael S.
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-08-30
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
Etiologies of a thickened stalk include inflammatory, neoplastic, and idiopathic origins, and the underlying diagnosis may remain occult.
We report a patient with a thickened pituitary stalk (TPS) and papillary thyroid carcinoma (PTC) whose diagnosis remained obscure until a skin lesion appeared.
The patient presented with PTC, status postthyroidectomy, and I131 therapy.
PTC molecular testing revealed BRAF mutant (V600E, GTC>GAG).
She had a 5-year history of polyuria/polydipsia.
Overnight dehydration study confirmed diabetes insipidus (DI).
MRI revealed TPS with loss of the posterior pituitary bright spot.
Evaluation showed hypogonadotropic hypogonadism and low IGF-1.
Chest X-ray and ACE levels were normal.
Radiographs to evaluate for extrapituitary sites of Langerhans Cell Histiocytosis (LCH) were unremarkable.
Germinoma studies were negative: normal serum and CSF beta-hCG, alpha-fetoprotein, and CEA.
Three years later, the patient developed vulvar labial lesions followed by inguinal region skin lesions, biopsy of which revealed LCH.
Reanalysis of thyroid pathology was consistent with concurrent LCH, PTC, and Hashimoto’s thyroiditis within the thyroid.
This case illustrates that one must be vigilant for extrapituitary manifestations of systemic diseases to diagnose the etiology of TPS.
An activating mutation of the protooncogene BRAF is a potential unifying etiology of both PTC and LCH.
American Psychological Association (APA)
Gordon, Michael S.& Gordon, Murray B.. 2016. Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus. Case Reports in Endocrinology،Vol. 2016, no. 2016, pp.1-3.
https://search.emarefa.net/detail/BIM-1100688
Modern Language Association (MLA)
Gordon, Michael S.& Gordon, Murray B.. Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus. Case Reports in Endocrinology No. 2016 (2016), pp.1-3.
https://search.emarefa.net/detail/BIM-1100688
American Medical Association (AMA)
Gordon, Michael S.& Gordon, Murray B.. Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus. Case Reports in Endocrinology. 2016. Vol. 2016, no. 2016, pp.1-3.
https://search.emarefa.net/detail/BIM-1100688
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1100688