Multifocal fibrosclerosis as a possible cause of panhypopituitarism with central diabetes insipidus

Multifocal fibrosclerosis denotes a combination of similar fibrous disorder s occurring at different anatomical sites. We encountered a 53-year-old mal e patient with orbital pseudotumor, chronic paranasal sinusitis, fibrous no dules of the lungs, intracranial pachymeningitis, and panhypopituitarism wi th central diabetes insipidus (DI) as a possible manifestation of multifoca l fibrosclerosis. It has been reported that intracranial pachymeningitis or orbital pseudotumor associated with multifocal fibrosclerosis could invade the sella turcica causing a variety of anterior and/or posterior pituitary dysfunctions. In our case, intracranial pachymeningitis apparently involve d the pituitary stalk and gland. Isolated gonadotropin deficiency, in addit ion to central DI, preceded panhypopituitarism. Although panhypopituitarism with central DI due to multifocal fibrosclerosis is quite rare and only on e case has ever been reported, this systemic fibrotic disorder can be a pos sible cause of panhypopituitarism with central DI.