An unusual association of corpus callosum agenesis in a patient with acromegaly.

DESCRIPTION Midline developmental abnormalities are usually associated with isolated growth hormone deficiency or multiple pituitary hormone deficiencies due to pituitary transcription factor defects.We describe a casewithmidline defects presenting as corpus callosum agenesis and acromegaly. A 39-year-old male presented with congestive cardiac failure with overt clinical features of acromegaly. He was a graduate, was mentally normal and had no visible morphological abnormality. On evaluation, serum growth hormone after 75 g of anhydrous glucose load was non-suppressible (12 μg/l, normal <1 μg/l) and insulin-like growth factor-1 was elevated (900 μg/l, normal 114–49 μg/l). He was hypothyroid, hypocortisolic and hypogonadal and was on replacement therapies. MRI of the head showed a pituitary macroadenoma (2×1.5×1 cm) with left parasellar extension and subacute apoplexy and incidental findings of complete agenesis of corpus callosum (ACC) and right cerebral hemiatrophy (figure 1 and 2). His karyotype was 46, XY with no chromosomal abnormalities. The patient underwent transsphenoidal surgery and was cured. The corpus callosum is a band of white matter structure connecting the cerebral hemispheres medially. It develops from the lamina reuniens in the telencephalon. ACC is an