Brain tumor presenting as anorexia nervosa in a 19-year-old man
Journal
Journal of the Formosan Medical Association
Journal Volume
102
Journal Issue
10
Pages
737-740
Date Issued
2003
Author(s)
Abstract
Slow-growing brain tumors can produce disturbances of food intake and endocrine dysfunction. We report a case of slow-growing midline brain tumor in a patient with clinical presentation of anorexia nervosa (AN). A 19-year-old man was referred from a general practitioner to a psychiatric clinic due to illness behavior and psychophathological characteristics of AN. His body weight had decreased from 52 kg to 40 kg within 6 months. Laboratory tests showed hypernatremia (160 mmol/L), adrenal insufficiency (adrenocorticotrophic hormone, 11.4 pg/mL; 8 am cortisol, 1.4 μg/dL; 4 pm cortisol, 11.4 μg/dL)and hypogonadotropic hypogonadism (testosterone < 0.5 ng/mL, follicle-stimulating hormone < 0.1 mIU/mL, luteinizing hormone < 0.7 mIU/mL). Brain magnetic resonance imaging showed an extensive mass lesion at suprasellar, hypothalamic region, third ventricle, pineal region, lateral ventricle, and corpus callosum. Owing to central herniation during physical assessment, he died of unknown intracranial pathology. This case suggests that an intracranial tumor near the hypothalamus should be included in the differential diagnosis of AN. Any male adolescent with the clinical impression of AN should receive periodic re-evaluation, including neurological, endocrinological and, if necessary, neuroimaging study.
SDGs
Other Subjects
corticotropin; follitropin; hydrocortisone; luteinizing hormone; testosterone; adrenal cortex insufficiency; adrenal insufficiency; adult; anorexia nervosa; article; body weight; brain hernia; brain third ventricle; brain tumor; case report; clinical feature; corpus callosum; corticotropin blood level; differential diagnosis; fatality; follitropin blood level; human; hydrocephalus; hydrocortisone blood level; hypernatremia; hypogonadism; hypogonadotropic hypogonadism; hypothalamus tumor; illness behavior; laboratory test; lateral brain ventricle; luteinizing hormone blood level; male; neurologic examination; nuclear magnetic resonance imaging; pineal body tumor; testosterone blood level; Adrenal Insufficiency; Adult; Anorexia Nervosa; Brain Neoplasms; Diagnosis, Differential; Fatal Outcome; Humans; Hydrocephalus; Hypernatremia; Hypogonadism; Male
Type
journal article