Lyphomatoid granulomatosis causing central diabetes insipidus: case report and review of the literature

Cancer Investigation
P W BushunowD B Duggan

Abstract

We report a patient with pulmonary and cutaneous lymphomatoid granulomatosis with central nervous system (CNS) involvement manifesting as central diabetes insipidus and review other cases reported in the literature with attention to presence of endocrine manifestations and response to therapy. Imaging of the pituitary in our patient demonstrated a thickened hypophyseal stalk and empty sella appearance. CHOP chemotherapy proved to be an effective treatment for both the systemic and CNS involvement in our patient, but diabetes insipidus has persisted. We postulate that there was localized involvement of the stalk of the hypophysis by lymphomatoid granulomatosis, which led to a permanent lesion causing diabetes insipidus. We conclude that lymphomatoid granulomatosis may cause endocrine complications that may not resolve despite systemic remission, and while the optimal regimen for CNS involvement with lymphomatoid granulomatosis is unknown, certain patients can have long-term survival after treatment with systemic chemotherapy. Endocrine complications of malignant diseases often present diagnostic and therapeutic challenges to the internist and neuro-oncologist. Lymphoproliferative disorders such as lymphomatoid granulomatosis and...Continue Reading

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Citations

Mar 25, 2014·Case Reports in Medicine·Takao KoisoAkira Matsumura
Aug 16, 2005·Radiology·Athos D PatsalidesWyndham H Wilson
Dec 24, 2014·Pituitary·Brandon S ImberManish K Aghi

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