Sagittal T1-W post-contrast (image 1) and T1-W precontrast ( | Figure 1
CincyKidsRad
Cincinnati Children's Radiology
Sagittal T1-W post-contrast (image 1) and T1-W precontrast (image 2) MRI shows nodular thickening (arrow) of the pituitary infundibulum and absence of the posterior pituitary bright spot. The differential diagnosis for infundibular masses in an adolescent include Langerhans cell histiocytosis, germinoma, and other inflammatory conditions such as sarcoid, or lymphocytic hypophysitis. This patient is thought to have a germinoma.
Germinomas are usually diagnosed in adolescence. They are most common in the pineal gland but also can occur in the suprasellar region or in the paraventricular basal ganglia. When they involve the infundibulum, as in this patient, they are associated with diabetes insipidus. #NeuroWednesday
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