Differential Diagnosis for Primary Partial Empty Sella Syndrome or Post-Inflammatory/Post-Infarct Atrophic Pituitary
- Single Most Likely Diagnosis
- Primary Partial Empty Sella Syndrome: This condition is characterized by the presence of a sella turcica that is partially filled with cerebrospinal fluid, often due to a defect in the diaphragma sellae. It can be asymptomatic or present with symptoms related to hormonal deficiencies. Given the description, this seems the most direct diagnosis.
- Other Likely Diagnoses
- Post-inflammatory or post-infarct atrophic pituitary: Conditions such as Sheehan syndrome (postpartum pituitary necrosis) or lymphocytic hypophysitis can lead to pituitary atrophy, which might resemble an empty sella on imaging. These conditions often have a clear precipitating event or clinical context.
- Pituitary adenoma with cystic degeneration or apoplexy: Although less common, a pituitary adenoma that has undergone cystic degeneration or apoplexy could potentially mimic the appearance of an empty sella or atrophic pituitary on imaging.
- Do Not Miss Diagnoses
- Pituitary apoplexy: This is a medical emergency where a pituitary tumor suddenly hemorrhages or infarcts, leading to acute symptoms. It's crucial to distinguish this from other causes of empty sella or pituitary atrophy due to its urgent need for treatment.
- Craniopharyngioma: Although rare, craniopharyngiomas can cause significant morbidity due to their location and potential to compress vital structures. They might present with symptoms similar to those of an empty sella or atrophic pituitary.
- Rare Diagnoses
- Lymphoma or metastasis to the pituitary: These are uncommon causes of pituitary dysfunction and could potentially lead to an appearance of an empty sella or atrophy on imaging due to tumor infiltration and destruction of pituitary tissue.
- Invasive or metastatic disease from other primary sites (e.g., breast, lung cancer): Similar to lymphoma, these conditions are rare but can affect the pituitary gland, leading to atrophy or a picture resembling an empty sella.