A woman with diabetes mellitus, hypertension, obesity, and prominent virilization was discovered to have an enlarged sella turcica. A pneumoencephalogram with tomographic views demonstrated the sella turcica was empty except for a thin layer of tissue on the sellar floor. Studies of the patient's pituitary and androgenic hormones showed that they were normal.
For reasons unclear, empty sellae occur predominantly in obese adult women, many of whom have hypertension and diabetes. Hirsutism is occasionally present, but actual virilization has not been noted previously.
Shore RN, DeCherney AH, Stein KM, Heaton CL. The Empty Sella Syndrome: Virilization in a 59-Year-Old Woman. JAMA. 1974;227(1):69–70. doi:10.1001/jama.1974.03230140039009
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