Pituitary Stalk Interruption Syndrome: MRI Diagnosis of a Rare Congenital Pituitary Disorder
When Hormonal Abnormalities Point to an Anatomical Diagnosis A young woman presents with a combination of endocrine abnormalities that initially appear to suggest a thyroid disorder. Her thyroid hormone level is low, prolactin is elevated, and there is evidence of broader pituitary dysfunction. She also has a history compatible with short stature and delayed pubertal development. At this point, the diagnostic question is larger than the thyroid gland. What happens when the underlying problem is not primarily biochemical, but anatomical? A dedicated pituitary MRI may provide the answer. When the anterior pituitary is hypoplastic, the pituitary stalk is thin or absent, and the posterior pituitary bright spot is missing from its normal location with an ectopic focus of T1 hyperintensity, the imaging pattern strongly suggests Pituitary Stalk Interruption Syndrome (PSIS) . PSIS is an uncommon congenital developmental abnormality of the hypothalamic-pituitary axis. Its clinical express...