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A new imaging entity consistent with partial ectopic posterior pituitary gland: report of six cases

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Abstract

Background

Abnormal posterior pituitary development including ectopic location has been associated with endocrine manifestations of anterior pituitary dysfunction.

Objective

We describe an unreported clinical and radiologic entity we call partial ectopic posterior pituitary for which associated endocrine consequences are not known.

Materials and methods

We selected pediatric head MRI examinations from 2005 to 2017 based on the finding of a double midline sellar and suprasellar bright spot on T1-weighted sequence. Medical history, physical examination, pituitary hormonal profile and bone age evaluation were extracted from the medical record of the selected patients. An experienced pediatric neuroradiologist reviewed head MRIs, which were performed on 3-tesla (T) magnet and included at least sagittal T1-weighted imaging centered on the sella turcica obtained with and without fat suppression.

Results

In six cases, two midline bright spots were identified on T1-weighted sequences obtained both with and without fat suppression. While one spot was located at the expected site of the neurohypophysis in the posterior sella, the second one was in the region of the median eminence, suggesting partial ectopic posterior pituitary gland. Growth hormone deficiency, either isolated (n=1) or combined with thyroid stimulating hormone deficiency (n=1) was found. None of the children had clinical signs of posterior pituitary dysfunction.

Conclusion

We describe an unreported imaging entity suggesting partial ectopic posterior pituitary gland in six children. Anterior pituitary hormone deficiencies might be detected in those children and long-term follow-up could provide additional information on the development of other pituitary hormone deficiencies.

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Acknowledgments

We would like to acknowledge the librarian Mariza Kazue for help with the literature review.

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Authors and Affiliations

  1. Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, QC, Canada

    Marina Ybarra

  2. Institut National de la recherche scientifique – Centre Armand-Frappier, Université du Québec, Laval, QC, Canada

    Marina Ybarra

  3. Department of Radiology, McGill University Health Centre, 1001 Decarie Blvd., Room B02.7006, Montreal, QC, H4A 3J1, Canada

    Rawan Hafiz & Christine Saint-Martin

  4. Division of Endocrinology, Department of Pediatrics, McGill University Health Centre, Montreal, QC, Canada

    Marie-Eve Robinson, Julia Elisabeth von Oettingen & Helen Bui

  5. Research Institute, McGill University Health Centre, Montreal, QC, Canada

    Julia Elisabeth von Oettingen

Authors
  1. Marina Ybarra
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  2. Rawan Hafiz
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  3. Marie-Eve Robinson
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  4. Julia Elisabeth von Oettingen
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  5. Helen Bui
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  6. Christine Saint-Martin
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Correspondence to Christine Saint-Martin.

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Ybarra, M., Hafiz, R., Robinson, ME. et al. A new imaging entity consistent with partial ectopic posterior pituitary gland: report of six cases. Pediatr Radiol 50, 107–115 (2020). https://doi.org/10.1007/s00247-019-04502-5

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  • DOI: https://doi.org/10.1007/s00247-019-04502-5

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