All issues > Volume 47(4); 2004

Case Report

Korean J Pediatr. 2004;47(4):453-457. Published online April 15, 2004.

A Case of Teratocarcinoma with Central Diabetes Insipidus

Jong Hoon JH Kim¹, In Seok IS Lim¹, Eung Sang ES Choi¹, Byoung Hoon BH Yoo¹

¹Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea

Correspondence In Seok IS Lim ,Email: kimjh0113@hanmail.net

Abstract

Central diabetes insipidus is a rare disorder that can result as a consequence of diverse etiologies, including malformations, autoimmune, infiltrative(e.g. neoplastic or histiocytosis) or traumatic processes, as well as mutations in the gene encoding arginine vasopressin. Idiopathic central diabetes insipidus is a diagnosis of exclusion, one that has been made less frequently through the decades. Idiopathic central diabetes insipidus in children and adolescent requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior lobe is observed. Also, so-called "idiopathic" central diabetes insipidus warrants close follow-up to determine the etiology, especially if anterior pituitary hormone deficiencies are detected. We report a case of idiopathic central diabetes insipidus with growth hormone deficiency and loss of a hyperintense signal in the posterior lobe of pituitary in the brain MRI. We followed up with serial contrast enhanced brain MRI and CSF evaluation for the early detection of an evolving occult hypothalamic-stalk lesion and finally detected a newly developed teratocarcinoma in the suprasellar region.

Keywords :Idiopathic central diabetes insipidus; Growth hormone deficiency; Posterior pituitary hyperintence signal; Teratocarcinoma