ODP344 Pituitary lymphoma: A case series in a referral center in Mexico City

Malignant lymphoma of the pituitary gland is extremely rare. The most common form of CNS involvement in lymphoma is leptomeningeal metastases, but it can also affect the spine or the cerebral parenchyma. Pituitary involvement usually presents as diabetes insipidus but can also present as hypopituitarism if there is adenohypophyseal destruction and may also present as bitemporal hemianopsia. (1)We present a case series of four patients with metastatic lymphomas to the pituitary gland that presented with diabetes insipidus to a tertiary center in Mexico City. Our investigation identified 4 patients with a previous diagnosis of lymphoma (3 B cell non-Hodgkin and 1 Hodgkin lymphoma) that were admitted into the endocrinology clinic with evidence of pituitary involvement and metastases to the pituitary gland. The average age of the cases was 54.5 years. 1 of the 4 patients had a diagnosis of HIV infections prior to the diagnosis of the lymphoma. Diabetes insipidus was present in 100% of the patients, while headache (75%) and visual field defects (50%) were the most common findings at presentation. Two of the patients also had involvement of the adenohypophysis and had hypocortisolism and central hypothyroidism that required hormone replacement therapy. All cases were documented by a lesion in the contrast enhancing lesion on MRI. Lymphoma involving the pituitary gland is particularly rare. In our series, involvement of the posterior pituitary was the most common form of presentation in contrast to the reported in other series, but the clinical presentation can be heterogenous, hence, it is important to perform an extensive endocrinological examination when pituitary involvement is suspected.1. Mathiasen RA, Jarrahy R, Cha ST, et al. Pituitary lymphoma: a case report and literature review. Pituitary. 2000;2(4): 283-287. doi: 10.1023/a: 1009969417380 Presentation: No date and time listed