Endocrine Manifestations of Intracranial Extrasellar Lesions

ABSTRACT. Fourteen patients with intracranial extrasellar lesions simulating primary pituitary disease are presented. Two had aneurysms of the internal carotid artery, 4 had tumors involving the third ventricle, 4 had internal hydrocephalus due to a block in the aqueduct of Sylvius, and 1 each had glioma of the optic chiasm, arteriovenous anomaly of the left cerebrum, meningioma of the floor of the anterior fossa and mucocele of the sphenoid sinus. Thirteen patients had clinical and laboratory evidences of hypothalamic-hypophysial dysfunction. Abnormality of gonadotropin secretion occurred in 10, of TSH secretion in 6, of ACTH secretion in 5, and 4 had diabetes insipidus. All the patients with third-ventricle tumors, glioma of the optic chiasm and arteriovenous anomaly and one of those with aneurysm of the internal carotid artery had the most extensive endocrine deficiencies. In several cases, substitution therapy with cortisone was crucial in carrying the patients through stressful experiences, and in th...