Pituitary dermoid and epidermoid cysts

What it is

From: Orphanet

Pituitary dermoid and epidermoid cysts is a rare, acquired pituitary hormone deficiency characterized by the presence of rare, benign tumor in the sellar region. Clinical presentation is either acute or insidious, and is variable according to the cyst location, size and potential rupture. Most commonly patients present with headache, visual disturbances, and pituitary dysfunction.

Reported clinical features and what the terms mean

The following findings are associated with this condition in Orphanet. They are not a checklist for diagnosing yourself, and they do not all occur in every affected person. Some are examination, imaging or laboratory findings that cannot be recognised at home.

The frequency labels describe how often a finding was reported among people with the condition in the source. They do not give the chance that a person with that symptom has the condition. Definitions below reproduce HPO terminology; they explain the term, not the likely severity in an individual.

Anterior hypopituitarism · Very frequent (99-80%)

A condition of reduced function of the anterior pituitary gland characterized by decreased secretion of one or more of the pituitary hormones growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, prolactin, luteinizing hormone, and follicle-stimulating hormone.

Avascular necrosis · Very frequent (99-80%)

A disease where there is cellular death (necrosis) of bone components due to interruption of the blood supply.

Nausea and vomiting · Very frequent (99-80%)

Nausea is a commonly encountered symptom that has been defined as an unpleasant painless subjective feeling that one will imminently vomit. Vomiting has been defined as the forceful expulsion of the contents of the stomach, duodenum, or jejunum through the oral cavity. While nausea and vomiting are often thought to exist on a temporal continuum, this is not always the case. There are situations when severe nausea may be present without emesis and less frequently, when emesis may be present without preceding nausea.

Neoplasm of the anterior pituitary · Very frequent (99-80%)

A tumor (abnormal growth of tissue) of the adenohypophysis, which is also known as the anterior lobe of the pituitary gland.

Amenorrhea · Frequent (79-30%)

Absence of menses for an interval of time equivalent to a total of more than (or equal to) 3 previous cycles or 6 months.

Diplopia · Frequent (79-30%)

Diplopia is a condition in which a single object is perceived as two images, it is also known as double vision.

Enlarged pituitary gland · Frequent (79-30%)

An abnormally increased size of the pituitary gland.

Galactorrhea · Frequent (79-30%)

Spontaneous flow of milk from the breast, unassociated with childbirth or nursing.

Generalized muscle weakness · Frequent (79-30%)

Generalized weakness or decreased strength of the muscles, affecting both distal and proximal musculature.

Hyperpituitarism · Frequent (79-30%)

Hypersecretion of one or more pituitary hormones. This can occur in conditions in which deficiency in the target organ leads to decreased hormonal feedback, or as a primary condition most usually in connection with a pituitary adenoma.

Hypogonadism · Frequent (79-30%)

A decreased functionality of the gonad.

Increased circulating prolactin concentration · Frequent (79-30%)

The presence of abnormally increased levels of prolactin in the blood. Prolactin is a peptide hormone produced by the anterior pituitary gland that plays a role in breast development and lactation during pregnancy.

Oligomenorrhea · Frequent (79-30%)

Infrequent menses (less than 6 per year or more than 35 days between cycles).

Panhypopituitarism · Frequent (79-30%)

A pituitary functional deficit affecting all the anterior pituitary hormones (growth hormone, thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, adrenocorticotropic hormone, and prolactin).

Other findings in the same source

From: Orphanet

Additional reported features include Recurrent paroxysmal headache (Frequent (79-30%)); Thunderclap headache (Frequent (79-30%)); Reduced visual acuity (Frequent (79-30%)); Abnormality of central motor function (Occasional (29-5%)); Abnormality of central sensory function (Occasional (29-5%)); Meningitis (Occasional (29-5%)); Oligozoospermia (Occasional (29-5%)); Seizure (Occasional (29-5%)); Polydipsia (Very rare (<4-1%)); Sudden loss of visual acuity (Very rare (<4-1%)). This is a selected summary, not a complete description of the condition.

When it may begin

From: Orphanet

Adult; Elderly

Which doctor should you see?

The suggested department for discussing Pituitary dermoid and epidermoid cysts is Endocrinology, with a endocrinologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which hormone or metabolic finding is important in this case?
• How should test timing and current medicines be taken into account?
• What follow-up would show whether the care plan is working?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Pituitary dermoid and epidermoid cysts. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.