Langerhans Cell Histiocytosis of the Pituitary Gland Presenting as Unilateral Reversible Central Visual Loss and a Contralateral Junctional Scotoma

A 28-year-old woman developed Langerhans cell histiocytosis involving the hypothalamic-pituitary axis and presented with acute vision loss in the left eye, a junctional scotoma in the right eye, panhypopituitarism, and diabetes insipidus. Following endoscopic transphenoidal excision of the lesion, her vision improved in the affected eye and the junctional scotoma disappeared from the other eye. This is an unusual case of Langerhans cell histiocytosis of the hypothalamic-pituitary axis leading to a reversible anterior chiasmal (junctional) syndrome.