Intracerebral Calcification in Central Diabetes Insipidus due to Ectopic Pinealoma: Case Report

We report the case of a 23-year-old man who presented with late-appearing intracerebral calcification during the course of central diabetes insipidus. He had been diagnosed as having ectopic pinealoma and had received brain irradiation at the age of 11 years. Bilateral calcifications of the basal ganglia and thalamus appeared 8 years after the development of diabetes insipidus. Thereafter, the calcified lesions increased in extent on follow-up computed tomograms. Though the influence of cranial irradiation was not ruled out, the lack of evidence for any underlying metabolic defect suggested that persistent hypernatremia (hyperosmolar dehydration) due to insufficiently treated diabetes insipidus was the most probable cause of the intracerebral lesions. This has been described in previous cases of nephrogenic diabetes insipidus associated with intracerebral calcification.