Partially Empty Sella Syndrome associated with gonadotrophic axis deficiency: a case report

Abstract

Empty thoracic saddle is a diagnosis made by Magnetic Resonance Imaging, which defines it as partial when less than 50% of the saddle is filled with cerebrospinal fluid (CSF) and the pituitary gland has a thickness ≥ 3 mm or total when more than 50% of the saddle is filled with cerebrospinal fluid. that 50% of the saddle is filled with CSF and the thickness of the gland is ≤ 2 mm in diameter. Associated with this condition, with prevalence of 8 to 35% in the general population, a high incidence of pituitary dysfunction was documented. This study aims to report the case of a male patient with hypogonadotrophic hypogonadism associated with the partially empty Sella. Coming from Coronel Mota Hospital, Boa Vista / RR, in follow-up at the Endocrinology outpatient clinic for diabetes control and thyroid nodule follow-up, the patient complains of reduced libido and erectile dysfunction. Magnetic resonance imaging (MRI), after identifying the low hormonal levels in the laboratory tests, confirming the clinical suspicion of hypogonadism, showed a hypophysis with a height of up to 0.3 cm, characterizing a partially empty túrcica saddle. It was then decided to treat the patient with testosterone replacement. Conclusion: Although the diagnosis of this syndrome is most frequently observed incidentally, the association with hormonal disorders makes it necessary to routinely screen for these changes in asymptomatic patients so that treatment is early, avoiding complications in the short and long term.