Rathke's cyst with ectopic neurohypophysis presenting as severe short stature with delayed puberty
A fourteen and half-year-old chirpy active girl with good scholastic performance having a small face with low set ears without any midline defects, born term of breech delivery of a non-consanguineous marriage presented to us with concerns of lack of height gain and puberty since 6 years age. There was no history of headache, visual defects, polyuria or polydypsia. Her height was 107.5 cm, height standard deviation score (SDS) was -7.8 (target height SDS: -0.24) with a height age of 5.5 years Sexual maturity rating was prepubertal. Her bone age was 6-7 years (Greulich-Pyle method). Hormonal evaluation revealed low insulin like Growth factor-1 (IGF-1), GHD, secondary hypocortisolism, low luteinizing hormone (LH) and follicle stimulating hormone (FSH) with increased prolactin []. Magnetic resonance imaging (MRI) brain revealed hypoplastic anterior pituitary with stalk agenesis (partial empty sella), with intrapituitary cyst measuring 0.3 cm in diameter, with ectopic posterior pituitary located in tuber cinereum of the hypothalamus [Figure –]. Optic nerve, olfactory bulbs, corpus callosum, and septum pellucidum were normal. A diagnosis of MPHD with intrapituitary RC and EN was made in a teenage girl who had presented with severe short stature and delayed puberty.