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9b - Answer: 61-year-old male presents with hypogonadism

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 61-year-old male presents with hypogonadism and decreased testosterone level.

(QUIZ ANSWER) PRIMARY FINDING: 

Empty sella. 

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

Empty sella may be a cause of diminished testosterone secretion or low-T syndrome. 

Scattered areas of gliosis are present throughout the brain, mild. 

Incidentally noted is arthrosis of the right temporomandibular joint. 

Left maxillary sinus disease. 

The supratentorial brain demonstrates normal or slightly diminished volume but the cerebellar vermis is atrophic. 

CONCLUSION

Empty sella versus pituitary hypoplasia with the former favored and might contribute to low testosterone syndrome. Cortisol and / or ACTH and TSH levels might also be checked at this junction.

LESSON 2, TOPIC 27

Case Challenge: Sella MRI Cases

Case Challenge

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Content reviewed: July 15, 2021

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