Advanced International Journal for Research

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Primary Hypophysitis Mimicking Gonadotroph Adenoma in a Patient with Central Diabetes Insipidus: A Diagnostic Pitfall

Author(s) Dr. Zineb Serhane, Dr. Zineb Eddebbarh, Dr. Sara Hassane, Prof. Dr. Zineb El Azime, Prof. Dr. Mohamed Amine Essafi, Prof. Dr. Hayat Aynaou, Prof. Dr. Houda Salhi
Country Morocco
Abstract Introduction: Primary hypophysitis is a rare inflammatory disorder that may mimic pituitary adenoma both clinically and radiologically, making etiological diagnosis challenging. We report a case illustrating this diagnostic pitfall.
Case Presentation: A 43-year-old woman presented with a 5-month history of severe polyuria–polydipsia, retro-orbital headaches, recent amenorrhea, and weight loss. Biological evaluation confirmed diabetes insipidus. Pituitary MRI showed an 11-mm intrasellar lesion with homogeneous enhancement and cavernous sinus extension, initially suggestive of macroadenoma, while hormonal findings raised suspicion of a gonadotroph adenoma. However, the remainder of the pituitary and etiological work-up was unremarkable. The absence of the posterior pituitary T1 bright spot and the rapid response to desmopressin confirmed CDI. Serial MRI follow-up demonstrated complete regression of the lesion, strongly supporting primary hypophysitis rather than gonadotroph adenoma. Persistent CDI and subsequent evolution toward a menopausal gonadotroph profile further supported the diagnosis.
Conclusion: This case highlights the importance of integrating endocrine, radiological, and longitudinal follow-up data to avoid unnecessary pituitary surgery.
Keywords Keywords: Primary hypophysitis, Central diabetes insipidus, Pituitary adenoma mimic, Gonadotroph adenoma, Polyuria–polydipsia syndrome, Pituitary MRI, Spontaneous regression
Field Medical / Pharmacy
Published In Volume 7, Issue 4, July-August 2026
Published On 2026-07-09
DOI https://doi.org/10.63363/aijfr.2026.v07i04.6812
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