{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:33:45Z","timestamp":1789011225505,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,5,14]],"date-time":"2013-05-14T00:00:00Z","timestamp":1368489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The significance of pituitary stalk thickening (PST) on magnetic resonance imaging (MRI) is often unclear. We evaluated presenting symptoms, MRI findings, clinical course, and outcome predictors of patients with PST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We used a computerized search of the medical record from 1995 to 2008 to identify patients with PST without pituitary mass on MRI. Baseline and follow\u2010up MRIs were reviewed in a blinded fashion. Relevant clinical data were abstracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>69 patients with reported PST and adequate imaging for review were identified; 42 met study criteria. Median age at first abnormal MRI was 13.6 years (range: 0.8\u201319.7); 43% were male. Median follow\u2010up was 3.4 years (range 0\u201312.8). Patients with diabetes insipidus (DI) were significantly more likely to have a neoplastic process than those without (<jats:italic>P<\/jats:italic>\u2009=\u20090.0008). Of 16 patients with DI, 8 (50%) had a neoplastic process, including germ cell tumor (n\u2009=\u20094), Langerhans cell histiocytosis (n\u2009=\u20093), and lymphoma (n\u2009=\u20091). Among patients with DI, 7 (44%) also developed anterior pituitary hormone dysfunction (APD), either at presentation or on pre\u2010biopsy follow\u2010up, including 6\/8 patients with stalk neoplasm and only 1\/8 patients with non\u2010neoplastic PST (<jats:italic>P<\/jats:italic>\u2009=\u20090.04). Twenty\u2010six patients presented without DI; none was found to have neoplasm of the stalk except one patient with craniopharyngioma. Progression of PST on follow\u2010up imaging was significantly associated with a subsequent neoplastic diagnosis (<jats:italic>P<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with PST without DI are unlikely to have a neoplastic process. Among patients with DI, APD or progressive stalk increase over time are predictive of neoplasia. Pediatr Blood Cancer 2013;60:1630\u20131635. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.24577","type":"journal-article","created":{"date-parts":[[2013,5,14]],"date-time":"2013-05-14T08:06:42Z","timestamp":1368518802000},"page":"1630-1635","source":"Crossref","is-referenced-by-count":37,"title":["Predictors of neoplastic disease in children with isolated pituitary stalk thickening"],"prefix":"10.1002","volume":"60","author":[{"given":"Nathan J.","family":"Robison","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Division of Hematology\/Oncology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay P.","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Radiology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengling","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Division of Hematology\/Oncology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan N.","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Division of Hematology\/Oncology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Kieran","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Division of Hematology\/Oncology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter E.","family":"Manley","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Division of Hematology\/Oncology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie E.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Goumnerova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Department of Neurosurgery Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Department of Neurosurgery Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Michael","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Department of Neurosurgery Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy B.","family":"London","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Division of Hematology\/Oncology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Ullrich","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Boston Children's Hospital Boston Massachusetts"},{"name":"Department of Neurology Boston Children's Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,14]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Pediatric neuroimaging","author":"Barkovich AJ","year":"2012"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19910901)68:5<1009::AID-CNCR2820680517>3.0.CO;2-R"},{"key":"e_1_2_5_4_1","first-page":"111","article-title":"Value of brain magnetic resonance imaging and tumor markers in the diagnosis and treatment of intracranial germinoma in children","volume":"33","author":"Tao Y","year":"2011","journal-title":"Zhongguo Yi Xue Ke Xue Yuan Xue Bao"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.83.9.3089"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0513"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24042"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-31-4-391"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1390635"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e3181c11713"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.05.2027"},{"key":"e_1_2_5_12_1","first-page":"533","article-title":"MR imaging of the brain in patients with diabetes insipidus","volume":"12","author":"Tien R","year":"1991","journal-title":"Am J Neuroradiol"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309023291002"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.82.5.1362"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000023536"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010053431403"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-8467(00)00063-9"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-27302011000700008"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP10409.CR"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.38.995"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP10040.CR"},{"key":"e_1_2_5_22_1","first-page":"455","article-title":"Metastasis to the pituitary stalk in a case of breast cancer","volume":"146","author":"Delattre JY","year":"1990","journal-title":"Rev Neurol (Paris)"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.84.6.1954"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20003"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004310051074"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000224342"}],"container-title":["Pediatric Blood &amp; 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