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Panhypopituitarism in a case of Rathke's cleft cyst (RCC) presenting as secondary amenorrhea.


Amity B. Casurao,
Ma. Socorro C. Bernardino,
Ma. Asuncion A. Fernandez

Related Institution

Section of Reproductive Endocrinology and Infertility - St. Luke's Medical Center

Publication Information

Publication Type
Publication Sub Type
Case report
Philippine Journal of Reproductive Endocrinology and Infertility
Publication Date
January-June 2014


A 17-year-old, nulligravid, presented with amenorrhea for three years after her menarche at 14 years of age. Various symptoms emerged including decreased appetite, severe weightloss, headache, stunted growth, regression of secondary sexual characteristics, weakness, somnolence and cold intolerance. Secondary amenorrhea and changes in the physical appearance were the main concerns prompting consult. Investigation revealed hypogonadotrophic hypogonadism, cortisol deficiency secondary to decreased ACTH, hypothyroidism and normal prolactin. Transrectal ultrasound showed a small uterus, thin endometrium and compact ovaries. Skeletal age was delayed by almost two years. Cranial MRI showed Rathke's Cyst. History, physical examination and work-up lead to the diagnosis of panhypopituitarism secondary to a pituitary cyst. Patient was monitored postoperatively for complications and response to medical and surgical treatment. This paper aims to discuss the evaluation of secondary amenorrhea accompanied by various symptoms leading to a diagnosis of panhypopituitarism in the hope of helping clinicians recognize more serious disorders which may have secondary amenorrhea as an initial manifestation.


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