Hypothalamic tumor associated with atypical forms of anorexia nervosa and diencephalic syndrome

Chipkevitch, Eugenio; Fernandes, Antonio C.L.

doi:10.1590/S0004-282X1993000200022

Abstracts

We report the case of a 10-year-old girl with a mature teratoma in the hypothalamic region. The patient presented a 2-month history of anorexia, psychic disturbances and a 37% loss of body weight. These symptoms had led initially to a diagnosis of major depression and atypical anorexia nervosa. She also presented some signs and symptoms of diencephalic syndrome. This case illustrates the importance of considering a slow-growing mass as a rare but real possibility in the differential diagnosis of anorexia nervosa, mainly in atypical cases.

hypothalamic tumor; teratoma; anorexia nervosa; diencephalic syndrome

Os autores relatam o caso de uma menina de 10 anos de idade com teratoma maduro na região hipotalâmica. A paciente apresentava história de 2 meses de anorexia, distúrbios psíquicos e perda de 37% de seu peso. Tais sintomas levaram inicialmente ao diagnóstico de depressão maior e anorexia nervosa atípica. Ela também apresentava alguns sinais e sintomas da síndrome diencefálica. O caso ilustra a importância de considerar tumores de crescimento lento como possibilidade rara, embora real, no diagnóstico diferencial de anorexia nervosa, particularmente em casos atípicos.

tumor hipotalâmico; teratoma; anorexia nervosa; síndrome diencefálica

Eugenio Chipkevitch; Antonio C.L. Fernandes

Division of Adolescent Medicine, Darcy Vargas Children's Hospital (SUDS), São Paulo

SUMMARY

We report the case of a 10-year-old girl with a mature teratoma in the hypothalamic region. The patient presented a 2-month history of anorexia, psychic disturbances and a 37% loss of body weight. These symptoms had led initially to a diagnosis of major depression and atypical anorexia nervosa. She also presented some signs and symptoms of diencephalic syndrome. This case illustrates the importance of considering a slow-growing mass as a rare but real possibility in the differential diagnosis of anorexia nervosa, mainly in atypical cases.

Key words: hypothalamic tumor, teratoma, anorexia nervosa, diencephalic syndrome.

RESUMO

Os autores relatam o caso de uma menina de 10 anos de idade com teratoma maduro na região hipotalâmica. A paciente apresentava história de 2 meses de anorexia, distúrbios psíquicos e perda de 37% de seu peso. Tais sintomas levaram inicialmente ao diagnóstico de depressão maior e anorexia nervosa atípica. Ela também apresentava alguns sinais e sintomas da síndrome diencefálica. O caso ilustra a importância de considerar tumores de crescimento lento como possibilidade rara, embora real, no diagnóstico diferencial de anorexia nervosa, particularmente em casos atípicos.

Palavras-chave: tumor hipotalâmico, teratoma, anorexia nervosa, síndrome diencefálica.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Aknowledgements We thank Drs. Hamilton Matushita and Nelio Garcia de Barros, from the Departments of Neurosurgery and Neuroradiology of the São Paulo University Clinical Hospital, for providing data on the patient's internation at their unit.

Aceite: 03-agosto-1992.

Dr. Eugênio Chipkevitch Rua Br. Jaceguai 1154/113 04606-002 São Paulo SP Brasil.

1. Addy DP, Hudson FP. Diencephalic syndrome of infantile emaciation: analysis of literature and report of further 3 cases. Arch Dis Child 1972, 47:338-343.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Ed 3, rev. Washington DC: American Psychiatric Association, 1987.
3. Anand BK, Rrobeck JR. Hypothalamic control of food intake in rats and cats. Yale J Biol Med 1951, 24:123-140.
4. Bruch H. Eating disorders: obesity, anorexia nervosa and the person within. New York: Basic Books, 1973.
5. Burr IM, Slonim AE, Danish RK. Diencephalic syndrome revisited. J Pediatr 1976, 88:439-441.
6. Carmel PW. Surgical syndromes of the hypothalamus. Clin Neurosurg 1980, 27:133-157.
7 Climo LH. Anorexia nervosa associated with hypothalamic tumor: the search for clinical-pathological correlations. Psychiat J Univ Ottawa 1982, 7:20-25.
8 Hollatz F, Ziolko HU. Zur Differentialdiagnose der Anorexia Nervosa. Munch Med Wschr 1976, 118:263-266.
9. Imura H, Kato Y, Nakai Y. Endocrine aspects of tumors arising from suprasellar, third ventricular regions. Progr Exp Tumor Res 1987, 30:313-324.
10. Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: natural hystory and pathogenesis. J Neurosurg 1985, 63:155-167.
11. Plum F, Van Uitert R. Nonendocrine disease and disorders of the hypothalamus. In Reichlin S (ed): The hypothalamus. New York: Raven Press, 1978, p 415-474.
12. Schwabe AD, Lippe BM, Chang J. Anorexia nervosa. Ann Intern Med 1981, 94:371-381.
13. Teitelbaum P, Epstein AN. The lateral hypothalamic syndrome: recovery of feeding and drinking after lateral hypothalamic lesions. Psychol Rev 1962, 69:74-90.
14. Weller RA, Weller EB. Anorexia nervosa in a patient with an infiltrating tumor of the hypothalamus. Am J Psychiatry 1982, 139:824-825.

Hypothalamic tumor associated with atypical forms of anorexia nervosa and diencephalic syndrome

Tumor hipotalâmico associado a formas atípicas de anorexia nervosa e síndrome diencefálica

Publication Dates

Publication in this collection
19 Jan 2011
Date of issue
June 1993

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Addy DP, Hudson FP. Diencephalic syndrome of infantile emaciation: analysis of literature and report of further 3 cases. Arch Dis Child 1972, 47:338-343.

[2] 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Ed 3, rev. Washington DC: American Psychiatric Association, 1987.

[3] 3. Anand BK, Rrobeck JR. Hypothalamic control of food intake in rats and cats. Yale J Biol Med 1951, 24:123-140.

[4] 4. Bruch H. Eating disorders: obesity, anorexia nervosa and the person within. New York: Basic Books, 1973.

[5] 5. Burr IM, Slonim AE, Danish RK. Diencephalic syndrome revisited. J Pediatr 1976, 88:439-441.

[6] 6. Carmel PW. Surgical syndromes of the hypothalamus. Clin Neurosurg 1980, 27:133-157.

[7] 7 Climo LH. Anorexia nervosa associated with hypothalamic tumor: the search for clinical-pathological correlations. Psychiat J Univ Ottawa 1982, 7:20-25.

[8] 8 Hollatz F, Ziolko HU. Zur Differentialdiagnose der Anorexia Nervosa. Munch Med Wschr 1976, 118:263-266.

[9] 9. Imura H, Kato Y, Nakai Y. Endocrine aspects of tumors arising from suprasellar, third ventricular regions. Progr Exp Tumor Res 1987, 30:313-324.

[10] 10. Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: natural hystory and pathogenesis. J Neurosurg 1985, 63:155-167.

[11] 11. Plum F, Van Uitert R. Nonendocrine disease and disorders of the hypothalamus. In Reichlin S (ed): The hypothalamus. New York: Raven Press, 1978, p 415-474.

[12] 12. Schwabe AD, Lippe BM, Chang J. Anorexia nervosa. Ann Intern Med 1981, 94:371-381.

[13] 13. Teitelbaum P, Epstein AN. The lateral hypothalamic syndrome: recovery of feeding and drinking after lateral hypothalamic lesions. Psychol Rev 1962, 69:74-90.

[14] 14. Weller RA, Weller EB. Anorexia nervosa in a patient with an infiltrating tumor of the hypothalamus. Am J Psychiatry 1982, 139:824-825.