From the Departments of Ophthalmology (Dr Kivelä), Internal Medicine (Dr Pelkonen), and Neurosurgery (Dr Heiskanen), Helsinki University Central Hospital, and the Language Center and Faculty of Education, University of Helsinki (Dr Oja), Helsinki, Finland.
Tumors in the suprasellar region may cause both visual and endocrinologic
symptoms. This association, well known to modern physicians, was established
during the 19th century. However, we have identified a 16th-century autopsy
report, written by the Dutch professor of anatomy Pieter Pauw (1564-1617),
which describes an 18-year-old girl who developed marked polyuria and subsequently
became totally blind from a cystic tumor compressing the optic chiasm. Based
on prevailing theories on the nature of diabetes, Pauw attributed the disease
to the kidneys. Undoubtedly, however, his lucid report is the earliest known
account of diabetes insipidus caused by an arachnoid cyst, the Rathke cleft
cyst, or craniopharyngioma in the region of the pouch of Rathke. The description
also gives insights into the role of anatomic dissections in late 16th-century
Kivelä T, Pelkonen R, Oja M, Heiskanen O. Diabetes Insipidus and Blindness Caused by a Suprasellar Tumor: Pieter Pauw's Observations From the 16th Century. JAMA. 1998;279(1):48–50. doi:10.1001/jama.279.1.48
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