{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:31:40Z","timestamp":1790015500855,"version":"4.0.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T00:00:00Z","timestamp":1642204800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T00:00:00Z","timestamp":1642204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"CAMS Innovation Fund for Medical Science","award":["CIFMS-2016-I2M-1-002"],"award-info":[{"award-number":["CIFMS-2016-I2M-1-002"]}]},{"name":"National Key Research and Development Program of China","award":["No.2016YFC0901501"],"award-info":[{"award-number":["No.2016YFC0901501"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The differential diagnosis of IgG4-related hypophysitis and other inflammatory diseases or tumors involving sellar region is challenging even after sellar biopsy. Sellar germinoma is usually infiltrated by lymphocytes or plasma cells, and may be confused with hypophysitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 36-year-old man with diabetes insipidus, elevated serum IgG4 level (336\u2009mg\/dl), and sellar mass was suspected to have IgG4-related hypophysitis, and no other lesion of IgG4-related disease was detected. After treated by prednisone and mycophenolate mofetil, the serum IgG4 decreased to 214\u2009mg\/dl. However, after withdrawal of the drugs, the IgG4 level increased to 308\u2009mg\/dl. Endocrine assessments revealed panhypopituitarism, and the sellar mass enlarged. Transsphenoidal sellar exploration and biopsy was conducted. Pathological examination showed that the lesion was germinoma with lymphocytes and plasma cells infiltration, and IgG4-staining was positive (70\/HPF, IgG4\/IgG ratio\u2009=\u200910%). The patient was then treated by cisplatin and etoposide. After four cycles of chemotherapy, the serum IgG4 was 201\u2009mg\/dl, and the sellar mass was invisible.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Sellar germinoma can mimic the clinical characteristics of IgG4-related hypophysitis. Poor response to glucocorticoids can be used as an exclusion criterion in the clinical diagnosis of IgG4-related hypophysitis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-021-00930-3","type":"journal-article","created":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T11:02:33Z","timestamp":1642244553000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sellar germinoma mimicking IgG4-related hypophysitis: a case report"],"prefix":"10.1186","volume":"22","author":[{"given":"Kang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Lian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,15]]},"reference":[{"issue":"6","key":"930_CR1","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1056\/NEJMra1104650","volume":"366","author":"JH Stone","year":"2012","unstructured":"Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med. 2012;366(6):539\u201351. https:\/\/doi.org\/10.1056\/NEJMra1104650.","journal-title":"N Engl J Med"},{"issue":"1","key":"930_CR2","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1136\/annrheumdis-2019-216561","volume":"79","author":"ZS Wallace","year":"2020","unstructured":"Wallace ZS, Naden RP, Chari S, Choi HK, Della-Torre E, Dicaire JF, et al. The 2019 American College of Rheumatology\/European league against rheumatism classification criteria for IgG4-related disease. Ann Rheum Dis. 2020;79(1):77\u201387. https:\/\/doi.org\/10.1136\/annrheumdis-2019-216561.","journal-title":"Ann Rheum Dis"},{"issue":"9976","key":"930_CR3","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1016\/S0140-6736(14)60720-0","volume":"385","author":"T Kamisawa","year":"2015","unstructured":"Kamisawa T, Zen Y, Pillai S, Stone JH. IgG4-related disease. Lancet (London, England). 2015;385(9976):1460\u201371.","journal-title":"Lancet (London, England)"},{"issue":"11","key":"930_CR4","doi-asserted-by":"publisher","first-page":"896","DOI":"10.7326\/0003-4819-141-11-200412070-00033","volume":"141","author":"HJ van der Vliet","year":"2004","unstructured":"van der Vliet HJ, Perenboom RM. Multiple pseudotumors in IgG4-associated multifocal systemic fibrosis. Ann Intern Med. 2004;141(11):896\u20137. https:\/\/doi.org\/10.7326\/0003-4819-141-11-200412070-00033.","journal-title":"Ann Intern Med"},{"issue":"11","key":"930_CR5","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1016\/j.humpath.2007.06.011","volume":"38","author":"S Wong","year":"2007","unstructured":"Wong S, Lam WY, Wong WK, Lee KC. Hypophysitis presented as inflammatory pseudotumor in immunoglobulin G4-related systemic disease. Hum Pathol. 2007;38(11):1720\u20133. https:\/\/doi.org\/10.1016\/j.humpath.2007.06.011.","journal-title":"Hum Pathol"},{"issue":"2","key":"930_CR6","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1007\/s11102-016-0773-7","volume":"20","author":"J Shikuma","year":"2017","unstructured":"Shikuma J, Kan K, Ito R, Hara K, Sakai H, Miwa T, et al. Critical review of IgG4-related hypophysitis. Pituitary. 2017;20(2):282\u201391. https:\/\/doi.org\/10.1007\/s11102-016-0773-7.","journal-title":"Pituitary."},{"issue":"12","key":"930_CR7","doi-asserted-by":"publisher","first-page":"3225","DOI":"10.1016\/j.ajpath.2016.08.020","volume":"186","author":"P Caturegli","year":"2016","unstructured":"Caturegli P, Di Dalmazi G, Lombardi M, Grosso F, Larman HB, Larman T, et al. Hypophysitis secondary to cytotoxic T-lymphocyte-associated protein 4 blockade: insights into pathogenesis from an autopsy series. Am J Pathol. 2016;186(12):3225\u201335. https:\/\/doi.org\/10.1016\/j.ajpath.2016.08.020.","journal-title":"Am J Pathol"},{"issue":"2","key":"930_CR8","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1530\/EJE-13-0642","volume":"170","author":"H Bando","year":"2014","unstructured":"Bando H, Iguchi G, Fukuoka H, Taniguchi M, Yamamoto M, Matsumoto R, et al. The prevalence of IgG4-related hypophysitis in 170 consecutive patients with hypopituitarism and\/or central diabetes insipidus and review of the literature. Eur J Endocrinol. 2014;170(2):161\u201372. https:\/\/doi.org\/10.1530\/EJE-13-0642.","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"930_CR9","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1111\/bpa.12459","volume":"27","author":"C Bernreuther","year":"2017","unstructured":"Bernreuther C, Illies C, Flitsch J, Buchfelder M, Buslei R, Glatzel M, et al. IgG4-related hypophysitis is highly prevalent among cases of histologically confirmed hypophysitis. Brain Pathol (Zurich, Switzerland). 2017;27(6):839\u201345.","journal-title":"Brain Pathol (Zurich, Switzerland)"},{"issue":"7","key":"930_CR10","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1210\/jc.2010-2970","volume":"96","author":"P Leporati","year":"2011","unstructured":"Leporati P, Landek-Salgado MA, Lupi I, Chiovato L, Caturegli P. IgG4-related hypophysitis: a new addition to the hypophysitis spectrum. J Clin Endocrinol Metab. 2011;96(7):1971\u201380. https:\/\/doi.org\/10.1210\/jc.2010-2970.","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"930_CR11","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1507\/endocrj.EJ19-0569","volume":"67","author":"H Takagi","year":"2020","unstructured":"Takagi H, Iwama S, Sugimura Y, Takahashi Y, Oki Y, Akamizu T, et al. Diagnosis and treatment of autoimmune and IgG4-related hypophysitis: clinical guidelines of the Japan Endocrine Society. Endocr J. 2020;67(4):373\u20138. https:\/\/doi.org\/10.1507\/endocrj.EJ19-0569.","journal-title":"Endocr J"},{"issue":"5","key":"930_CR12","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1007\/s11102-015-0650-9","volume":"18","author":"H Bando","year":"2015","unstructured":"Bando H, Iguchi G, Fukuoka H, Taniguchi M, Kawano S, Saitoh M, et al. A diagnostic pitfall in IgG4-related hypophysitis: infiltration of IgG4-positive cells in the pituitary of granulomatosis with polyangiitis. Pituitary. 2015;18(5):722\u201330. https:\/\/doi.org\/10.1007\/s11102-015-0650-9.","journal-title":"Pituitary."},{"issue":"4","key":"930_CR13","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1007\/s12022-010-9128-5","volume":"21","author":"H Nishioka","year":"2010","unstructured":"Nishioka H, Shibuya M, Haraoka J. Immunohistochemical study for IgG4-positive plasmacytes in pituitary inflammatory lesions. Endocr Pathol. 2010;21(4):236\u201341. https:\/\/doi.org\/10.1007\/s12022-010-9128-5.","journal-title":"Endocr Pathol"},{"key":"930_CR14","doi-asserted-by":"publisher","unstructured":"Committee of Brain Tumor Registry of Japan. Report of Brain Tumor Registry of Japan (1969\u20131996). Neurologia medico-chirurgica. 2003;43 Suppl:i-vii, 1\u2013111. https:\/\/doi.org\/10.2176\/nmc.43.S1.","DOI":"10.2176\/nmc.43.S1"},{"issue":"7","key":"930_CR15","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1590\/S0004-27302013000700012","volume":"57","author":"MF Guzzo","year":"2013","unstructured":"Guzzo MF, Bueno CB, Amancio TT, Rosemberg S, Bueno C, Arioli EL, et al. An intrasellar germinoma with normal tumor marker concentrations mimicking primary lymphocytic hypophysitis. Arq Bras Endocrinol Metabol. 2013;57(7):566\u201370. https:\/\/doi.org\/10.1590\/S0004-27302013000700012.","journal-title":"Arq Bras Endocrinol Metabol"},{"issue":"2","key":"930_CR16","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s11060-013-1114-6","volume":"113","author":"JE Bromberg","year":"2013","unstructured":"Bromberg JE, Baumert BG, de Vos F, Gijtenbeek JM, Kurt E, Westermann AM, et al. Primary intracranial germ-cell tumors in adults: a practical review. J Neuro-Oncol. 2013;113(2):175\u201383. https:\/\/doi.org\/10.1007\/s11060-013-1114-6.","journal-title":"J Neuro-Oncol"},{"issue":"9","key":"930_CR17","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1177\/0883073818772470","volume":"33","author":"Z Kong","year":"2018","unstructured":"Kong Z, Wang Y, Dai C, Yao Y, Ma W, Wang Y. Central nervous system germ cell tumors: a review of the literature. J Child Neurol. 2018;33(9):610\u201320. https:\/\/doi.org\/10.1177\/0883073818772470.","journal-title":"J Child Neurol"},{"issue":"5","key":"930_CR18","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1159\/000501886","volume":"110","author":"R Pal","year":"2019","unstructured":"Pal R, Rai A, Vaiphei K, Gangadhar P, Dutaa P. Intracranial Germinoma masquerading as secondary granulomatous Hypophysitis: a case report and review of literature. Neuroendocrinology. 2019;110(5):422\u20139. https:\/\/doi.org\/10.1159\/000501886.","journal-title":"Neuroendocrinology."},{"key":"930_CR19","volume-title":"WHO classification of Tumours of the central nervous system","author":"DN Louis","year":"2007","unstructured":"Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. WHO classification of Tumours of the central nervous system. 4th edition ed. Lyon: IARC; 2007.","edition":"4th edition ed"},{"issue":"3","key":"930_CR20","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1007\/s00428-019-02564-2","volume":"475","author":"S Uccella","year":"2019","unstructured":"Uccella S, Amaglio C, Brouland JP, Bianconi E, Ippolito S, Messerer M, et al. Disease heterogeneity in IgG4-related hypophysitis: report of two histopathologically proven cases and review of the literature. Virchows Arch: Int J Pathol. 2019;475(3):373\u201381. https:\/\/doi.org\/10.1007\/s00428-019-02564-2.","journal-title":"Virchows Arch: Int J Pathol"},{"issue":"9","key":"930_CR21","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1038\/modpathol.2012.72","volume":"25","author":"V Deshpande","year":"2012","unstructured":"Deshpande V, Zen Y, Chan JK, Yi EE, Sato Y, Yoshino T, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol: Off J U S Can Acad Pathol Inc. 2012;25(9):1181\u201392. https:\/\/doi.org\/10.1038\/modpathol.2012.72.","journal-title":"Mod Pathol: Off J U S Can Acad Pathol Inc"},{"issue":"3","key":"930_CR22","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1007\/s11102-011-0338-8","volume":"15","author":"MA Landek-Salgado","year":"2012","unstructured":"Landek-Salgado MA, Leporati P, Lupi I, Geis A, Caturegli P. Growth hormone and proopiomelanocortin are targeted by autoantibodies in a patient with biopsy-proven IgG4-related hypophysitis. Pituitary. 2012;15(3):412\u20139. https:\/\/doi.org\/10.1007\/s11102-011-0338-8.","journal-title":"Pituitary."},{"issue":"3","key":"930_CR23","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s11102-016-0780-8","volume":"20","author":"N Iwata","year":"2017","unstructured":"Iwata N, Iwama S, Sugimura Y, Yasuda Y, Nakashima K, Takeuchi S, et al. Anti-pituitary antibodies against corticotrophs in IgG4-related hypophysitis. Pituitary. 2017;20(3):301\u201310. https:\/\/doi.org\/10.1007\/s11102-016-0780-8.","journal-title":"Pituitary."},{"issue":"1","key":"930_CR24","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s11882-015-0580-7","volume":"16","author":"S Crescioli","year":"2016","unstructured":"Crescioli S, Correa I, Karagiannis P, Davies AM, Sutton BJ, Nestle FO, et al. IgG4 characteristics and functions in Cancer immunity. Curr Allergy Asthma Rep. 2016;16(1):7. https:\/\/doi.org\/10.1007\/s11882-015-0580-7.","journal-title":"Curr Allergy Asthma Rep"},{"issue":"1","key":"930_CR25","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1002\/hep.25627","volume":"56","author":"K Harada","year":"2012","unstructured":"Harada K, Shimoda S, Kimura Y, Sato Y, Ikeda H, Igarashi S, et al. Significance of immunoglobulin G4 (IgG4)-positive cells in extrahepatic cholangiocarcinoma: molecular mechanism of IgG4 reaction in cancer tissue. Hepatology (Baltimore, Md). 2012;56(1):157\u201364.","journal-title":"Hepatology (Baltimore, Md)"},{"issue":"2","key":"930_CR26","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.berh.2016.07.003","volume":"30","author":"P Brito-Zer\u00f3n","year":"2016","unstructured":"Brito-Zer\u00f3n P, Bosch X, Ramos-Casals M, Stone JH. IgG4-related disease: advances in the diagnosis and treatment. Best Pract Res Clin Rheumatol. 2016;30(2):261\u201378. https:\/\/doi.org\/10.1016\/j.berh.2016.07.003.","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"4","key":"930_CR27","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1007\/s11102-009-0187-x","volume":"14","author":"A Gutenberg","year":"2011","unstructured":"Gutenberg A, Bell JJ, Lupi I, Tzou SC, Landek-Salgado MA, Kimura H, et al. Pituitary and systemic autoimmunity in a case of intrasellar germinoma. Pituitary. 2011;14(4):388\u201394. https:\/\/doi.org\/10.1007\/s11102-009-0187-x.","journal-title":"Pituitary."},{"issue":"2","key":"930_CR28","doi-asserted-by":"publisher","first-page":"e000661","DOI":"10.1136\/jitc-2020-000661","volume":"8","author":"H Wang","year":"2020","unstructured":"Wang H, Xu Q, Zhao C, Zhu Z, Zhu X, Zhou J, et al. An immune evasion mechanism with IgG4 playing an essential role in cancer and implication for immunotherapy. J Immunother Cancer. 2020;8(2):e000661.","journal-title":"J Immunother Cancer"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00930-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-021-00930-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-021-00930-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T11:05:52Z","timestamp":1642244752000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-021-00930-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,15]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["930"],"URL":"https:\/\/doi.org\/10.1186\/s12902-021-00930-3","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,15]]},"assertion":[{"value":"8 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23"}}