Duplicated Pituitary Gland
- Background:
- Duplication of the pituitary gland is a craniofacial developmental anomaly that occurs during blastogenesis, with postulated etiology such as incomplete twinning, teratogens, median cleft face syndrome, or splitting of the notochord.
- Clinical Presentation:
- All reported cases have shown accompanying abnormalities of the face or brain.
- Midline craniofacial abnormalities are commonly associated with duplication of the pituitary gland.
- Associated abnormalities include hypertelorism, cleft palate, mouth and tongue dysmorphism, persistence of the craniopharyngeal canal, midline clival defects, choanal atresia, and ectopic adenohypophyseal or hamartomatous pharyngeal masses.
- Key Diagnostic Features:
- Visualization of the duplicated infundibulum and pituitary gland is diagnostic.
- A characteristic elongated midline mass or thickening at the floor of the third ventricle is the most common intracranial abnormality associated with pituitary duplication.
- Differential Diagnoses:
- The appearances of the pituitary gland and infundibulum are pathognomic.
- The differential diagnoses of an associated homogeneous mass at the floor of the third ventricle includes hypothalamic hamartoma and hypothalamic glioma.
- Treatment:
- Resection of the teratoma and repair of the facial defect
- Pharmacologic treatment of abnormal hormonal levels, if present