Case 25-2008 -- A 43-Year-Old Man with Fatigue and Lesions in the Pituitary and Cerebellum

doi:10.1056/NEJMcpc0804623

Volume 359:736-747		August 14, 2008		Number 7

Case 25-2008 — A 43-Year-Old Man with Fatigue and Lesions in the Pituitary and Cerebellum

John A. Mills, M.D., R. Gilberto Gonzalez, M.D., Ph.D., and Ronald Jaffe, M.D.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

Full Text

PDF

PDA Full Text

PowerPoint Slide Set

CME Exam

Supplementary Material

Purchase this article

Add to Personal Archive

Add to Citation Manager

Notify a Friend

E-mail When Cited

E-mail When Letters Appear

PubMed Citation

Presentation of Case

Dr. Flavia V. Castelino (Rheumatology, Allergy, and Immunology):A 43-year-old man was seen in the neuro-oncology clinic of thishospital because of fatigue and lesions in the pituitary andcerebellum detected on radiography. He had been well until approximately9 years earlier, when thirst, insomnia, fatigue, and arthralgiasdeveloped. On evaluation at another facility, a diagnosis ofdiabetes insipidus was made, and desmopressin was prescribed.The symptoms resolved; however, during the next several years,he and his wife were unable to conceive a second child. Approximately3 years earlier, insomnia, fatigue, and joint pain recurred,associated with cold intolerance. Evaluation . . . [Full Text of this Article]

Differential Diagnosis

Hypopituitarism

Sarcoidosis

Retroperitoneal Fibrosis

Aortitis

Histiocytoses

Dr. John A. Mills's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Rheumatology, Allergy, and Immunology Division (J.A.M.) and the Department of Radiology (R.G.G.), Massachusetts General Hospital, Boston; the Departments of Rheumatology (J.A.M.) and Radiology (R.G.G.), Harvard Medical School, Boston; and the Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh (R.J.).