Incidental finding of a nasopharyngeal mass in an anterior pituitary insufficiency setting

Lara Delcour (1), Marie-Anne Labaisse (2), Carine Hinkeltz (3) Published in the journal : December 2018 Category : Endocrinology, Otorhinolaryngology

Summary :

The differential diagnosis of nasopharyngeal masses is vast and mainly comprises three categories of lesions: benign masses corresponding to benign tumors and inflammatory lesions, malignant tumors, and congenital lesions. The age of the patient, clinical context, symptoms associated with the mass, as well as iconographic data are essential to orientate professionals towards the various possible etiologies. In a context of hypothalamic-pituitary axis malformation, and with reference to the embryological origins of the pituitary gland, the hypothesis of extracranial ectopic pituitary tissue is, although rare, an etiology that must be evoked when confronted to a nasopharyngeal mass. However, biopsy with an anatomopathological examination proved to be the only technique able to confirm the lesion’s histological origin.

What is already known about the topic?

The first case of ectopic pituitary tissue was described by Erdheim and Stumme in 1909. Since then, the presence of anterior pituitary tissue in the nasopharyngeal wall has been demonstrated in several studies. Two cases of suspected pituitary ectopic tissue with associated pituitary abnormalities have been described in the medical literature, as well as several other cases of pituitary ectopic nasopharyngeal adenomas.

What does this article bring up for us?

The article presents a rare etiology of anterior pituitary insufficiency. It further discusses the differential diagnosis of nasopharyngeal masses, reporting on the hypothesis of ectopic pituitary tissue, the embryological origins of the pituitary gland, diagnostic methods, as well as therapeutic attitude towards this malformation type.

Key words

Anterior pituitary insufficiency, MRI, nasopharyngeal mass, differential diagnosis, embryology, ectopic pituitary tissue