Diabetes insipidus secondary to sellar/parasellar lesions. 2021

Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
1st Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Diabetes insipidus (DI) is a well-recognised transient or permanent complication following transsphenoidal surgery for pituitary adenomas or other sellar/parasellar lesions. However, data regarding the prevalence of pre-operative DI in sellar/parasellar lesions other than pituitary adenomas are scarce. We systematically reviewed the existing data for defining the prevalence of DI before any treatment in adult patients with sellar/parasellar lesions, excluding pituitary adenomas and metastatic lesions. In total, 646 patients with sellar/parasellar lesions presenting with DI at diagnosis were identified. The most common pathologies of sellar/parasellar lesions presenting with DI at diagnosis were lymphocytic hypophysitis (26.5%), craniopharyngiomas (23.4%), Langerhans's cell histiocytosis (18.9%) and Rathke's cleft cyst (12.7%), accounting for the vast majority (more than 80%) of these lesions. Overall, DI at diagnosis was found in 23.4% of all patients with sellar/parasellar lesions, albeit with a wide range from 10.6% to 76.7%, depending on the nature of the pathology. The highest prevalence of DI was found in less commonly encountered lesions namely germ-cell tumours (76.7%), abscesses (55.4%) and neurosarcoidosis (54.5%), each accounting for less than 3% of all sellar/parasellar lesions. Most DI cases (68.8%) were associated with anterior pituitary hormonal deficiencies, in contrast to pituitary adenomas that rarely present with DI. The enlargement and enhancement of the pituitary stalk were the most common findings on magnetic resonance imaging besides the loss of the high signal of the posterior pituitary on T1-weighted images. Resolution of DI spontaneously or following systemic and surgical management occurred in 22.4% of cases. Post-operative DI, not evident before surgery, was found in 27.8% of non-adenomatous sellar/parasellar lesions, and was transient in 11.6% of them. Besides distinctive imaging features and symptoms, early recognition of DI in such lesions is important because it directs the diagnosis towards a non-adenomatous sellar/parasellar tumour and the early initiation of appropriate treatment.

UI MeSH Term Description Entries
D010900 Pituitary Diseases Disorders involving either the ADENOHYPOPHYSIS or the NEUROHYPOPHYSIS. These diseases usually manifest as hypersecretion or hyposecretion of PITUITARY HORMONES. Neoplastic pituitary masses can also cause compression of the OPTIC CHIASM and other adjacent structures. Adenohypophyseal Diseases,Hypophyseal Disorders,Neurohypophyseal Diseases,Anterior Pituitary Diseases,Pituitary Disorders,Pituitary Gland Diseases,Posterior Pituitary Diseases,Adenohypophyseal Disease,Anterior Pituitary Disease,Disease, Adenohypophyseal,Disease, Anterior Pituitary,Disease, Neurohypophyseal,Disease, Pituitary,Disease, Pituitary Gland,Disease, Posterior Pituitary,Diseases, Adenohypophyseal,Diseases, Anterior Pituitary,Diseases, Neurohypophyseal,Diseases, Pituitary,Diseases, Pituitary Gland,Diseases, Posterior Pituitary,Disorder, Hypophyseal,Disorder, Pituitary,Disorders, Hypophyseal,Disorders, Pituitary,Hypophyseal Disorder,Neurohypophyseal Disease,Pituitary Disease,Pituitary Disease, Anterior,Pituitary Disease, Posterior,Pituitary Diseases, Anterior,Pituitary Diseases, Posterior,Pituitary Disorder,Pituitary Gland Disease,Posterior Pituitary Disease
D010911 Pituitary Neoplasms Neoplasms which arise from or metastasize to the PITUITARY GLAND. The majority of pituitary neoplasms are adenomas, which are divided into non-secreting and secreting forms. Hormone producing forms are further classified by the type of hormone they secrete. Pituitary adenomas may also be characterized by their staining properties (see ADENOMA, BASOPHIL; ADENOMA, ACIDOPHIL; and ADENOMA, CHROMOPHOBE). Pituitary tumors may compress adjacent structures, including the HYPOTHALAMUS, several CRANIAL NERVES, and the OPTIC CHIASM. Chiasmal compression may result in bitemporal HEMIANOPSIA. Pituitary Cancer,Cancer of Pituitary,Cancer of the Pituitary,Pituitary Adenoma,Pituitary Carcinoma,Pituitary Tumors,Adenoma, Pituitary,Adenomas, Pituitary,Cancer, Pituitary,Cancers, Pituitary,Carcinoma, Pituitary,Carcinomas, Pituitary,Neoplasm, Pituitary,Neoplasms, Pituitary,Pituitary Adenomas,Pituitary Cancers,Pituitary Carcinomas,Pituitary Neoplasm,Pituitary Tumor,Tumor, Pituitary,Tumors, Pituitary
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000236 Adenoma A benign epithelial tumor with a glandular organization. Adenoma, Basal Cell,Adenoma, Follicular,Adenoma, Microcystic,Adenoma, Monomorphic,Adenoma, Papillary,Adenoma, Trabecular,Adenomas,Adenomas, Basal Cell,Adenomas, Follicular,Adenomas, Microcystic,Adenomas, Monomorphic,Adenomas, Papillary,Adenomas, Trabecular,Basal Cell Adenoma,Basal Cell Adenomas,Follicular Adenoma,Follicular Adenomas,Microcystic Adenoma,Microcystic Adenomas,Monomorphic Adenoma,Monomorphic Adenomas,Papillary Adenoma,Papillary Adenomas,Trabecular Adenoma,Trabecular Adenomas
D012658 Sella Turcica A bony prominence situated on the upper surface of the body of the sphenoid bone. It houses the PITUITARY GLAND. Sella Turcicas,Turcica, Sella,Turcicas, Sella
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D020790 Diabetes Insipidus, Neurogenic A genetic or acquired polyuric disorder caused by a deficiency of VASOPRESSINS secreted by the NEUROHYPOPHYSIS. Clinical signs include the excretion of large volumes of dilute URINE; HYPERNATREMIA; THIRST; and polydipsia. Etiologies include HEAD TRAUMA; surgeries and diseases involving the HYPOTHALAMUS and the PITUITARY GLAND. This disorder may also be caused by mutations of genes such as ARVP encoding vasopressin and its corresponding neurophysin (NEUROPHYSINS). Central Diabetes Insipidus,Diabetes Insipidus Cranial Type,Diabetes Insipidus Primary Central,Diabetes Insipidus Secondary To Vasopressin Deficiency,Diabetes Insipidus, Central,Diabetes Insipidus, Cranial Type,Diabetes Insipidus, Neurohypophyseal,Diabetes Insipidus, Neurohypophyseal Type,Diabetes Insipidus, Pituitary,Diabetes Insipidus, Primary Central,Neurogenic Diabetes Insipidus,Neurohypophyseal Diabetes Insipidus,Pituitary Diabetes Insipidus,Vasopressin Defective Diabetes Insipidus,Vasopressin Deficiency

Related Publications

Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
January 1991, Clinical neurosurgery,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
April 2021, Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
February 2007, Clinical neurology and neurosurgery,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
March 2011, Nihon rinsho. Japanese journal of clinical medicine,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
July 1985, Journal of the Indian Medical Association,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
January 1970, Clinical neurosurgery,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
July 1984, Clinical radiology,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
December 1988, The Laryngoscope,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
December 2014, World neurosurgery,
Anna Angelousi, and Chrysoula Mytareli, and Paraskevi Xekouki, and Eva Kassi, and Konstantinos Barkas, and Ashley Grossman, and Gregory Kaltsas
May 1990, Clinical imaging,
Copied contents to your clipboard!