Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism

Abstract Background Pituitary stalk interruption syndrome (PSIS) is a rare congenital malformation of the pituitary stalk that leads to hypopituitarism, presenting with a variety of endocrine dysfunctions, including delayed puberty, short stature, and hypothyroidism. Magnetic resonance imaging (MRI)...

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Main Authors: Bayar Ahmed Qasim, Abdlaziz Brifkani, Ali H. Ali, Maryam M. Alias, Nada O. Dawod, Abdulkareem M. Jomaa, Halder J. Abozait
Format: Article
Language:English
Published: SpringerOpen 2025-08-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
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Online Access:https://doi.org/10.1186/s43055-025-01550-w
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author Bayar Ahmed Qasim
Abdlaziz Brifkani
Ali H. Ali
Maryam M. Alias
Nada O. Dawod
Abdulkareem M. Jomaa
Halder J. Abozait
author_facet Bayar Ahmed Qasim
Abdlaziz Brifkani
Ali H. Ali
Maryam M. Alias
Nada O. Dawod
Abdulkareem M. Jomaa
Halder J. Abozait
author_sort Bayar Ahmed Qasim
collection DOAJ
description Abstract Background Pituitary stalk interruption syndrome (PSIS) is a rare congenital malformation of the pituitary stalk that leads to hypopituitarism, presenting with a variety of endocrine dysfunctions, including delayed puberty, short stature, and hypothyroidism. Magnetic resonance imaging (MRI) typically reveals a thin or absent pituitary stalk, hypoplasia of the anterior pituitary, and ectopic posterior pituitary. This case aims to highlight the importance of early recognition and multidisciplinary management to improve long-term outcomes in patients with PSIS. Case presentation We present a 21-year-old male with delayed puberty and multiple endocrine abnormalities, including hypothyroidism, hypogonadism, and cortisol insufficiency. The patient exhibited physical features such as a depressed nasal bridge, macroglossia, and a short, wide neck. MRI revealed a hypoplastic anterior pituitary, absent pituitary stalk, and an ectopic posterior pituitary. Laboratory findings included elevated TSH, prolactin, and low levels of free T4, testosterone, and cortisol. Treatment with levothyroxine, prednisolone, and chorionic gonadotropin was initiated. After 3 months, laboratory values improved, although hormone levels remained abnormal. Conclusions This case highlights the importance of early detection and appropriate treatment for PSIS. MRI is a crucial diagnostic tool for patients presenting with hypopituitarism. A multidisciplinary approach to managing PSIS, including lifelong monitoring and tailored interventions, is essential for optimizing patient outcomes and addressing both endocrine and developmental concerns.
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spelling doaj-art-330d4b41f972417aaa721f36e9dc83972025-08-20T03:04:36ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622025-08-015611510.1186/s43055-025-01550-wPituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarismBayar Ahmed Qasim0Abdlaziz Brifkani1Ali H. Ali2Maryam M. Alias3Nada O. Dawod4Abdulkareem M. Jomaa5Halder J. Abozait6University of DuhokUniversity of DuhokUniversity of DuhokDirectorate of healthDirectorate of healthUniversity of DuhokUniversity of DuhokAbstract Background Pituitary stalk interruption syndrome (PSIS) is a rare congenital malformation of the pituitary stalk that leads to hypopituitarism, presenting with a variety of endocrine dysfunctions, including delayed puberty, short stature, and hypothyroidism. Magnetic resonance imaging (MRI) typically reveals a thin or absent pituitary stalk, hypoplasia of the anterior pituitary, and ectopic posterior pituitary. This case aims to highlight the importance of early recognition and multidisciplinary management to improve long-term outcomes in patients with PSIS. Case presentation We present a 21-year-old male with delayed puberty and multiple endocrine abnormalities, including hypothyroidism, hypogonadism, and cortisol insufficiency. The patient exhibited physical features such as a depressed nasal bridge, macroglossia, and a short, wide neck. MRI revealed a hypoplastic anterior pituitary, absent pituitary stalk, and an ectopic posterior pituitary. Laboratory findings included elevated TSH, prolactin, and low levels of free T4, testosterone, and cortisol. Treatment with levothyroxine, prednisolone, and chorionic gonadotropin was initiated. After 3 months, laboratory values improved, although hormone levels remained abnormal. Conclusions This case highlights the importance of early detection and appropriate treatment for PSIS. MRI is a crucial diagnostic tool for patients presenting with hypopituitarism. A multidisciplinary approach to managing PSIS, including lifelong monitoring and tailored interventions, is essential for optimizing patient outcomes and addressing both endocrine and developmental concerns.https://doi.org/10.1186/s43055-025-01550-wPituitary stalk interruption syndrome (PSIS)Congenital hypopituitarismEctopic neurohypophysis
spellingShingle Bayar Ahmed Qasim
Abdlaziz Brifkani
Ali H. Ali
Maryam M. Alias
Nada O. Dawod
Abdulkareem M. Jomaa
Halder J. Abozait
Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism
The Egyptian Journal of Radiology and Nuclear Medicine
Pituitary stalk interruption syndrome (PSIS)
Congenital hypopituitarism
Ectopic neurohypophysis
title Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism
title_full Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism
title_fullStr Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism
title_full_unstemmed Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism
title_short Pituitary stalk interruption syndrome (PSIS): a rare cause of congenital hypopituitarism
title_sort pituitary stalk interruption syndrome psis a rare cause of congenital hypopituitarism
topic Pituitary stalk interruption syndrome (PSIS)
Congenital hypopituitarism
Ectopic neurohypophysis
url https://doi.org/10.1186/s43055-025-01550-w
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