The pituitary bright spot is acknowledged to indicate functional integrity of the posterior pituitary gland, whilst its absence supports a diagnosis of central @entity2010 ( @entity2010 ). This feature was evaluated, together with the incidence and clinical characteristics of @entity2010 in @entity1 with @entity4611 . We performed a review of all suprasellar (SS) or bifocal (BF) @entity3438 @entity4806 @entity1 treated in Toronto since 2000. Demographics, symptomatology, treatment outcome and imaging were evaluated. Nineteen @entity1 fulfilled inclusion criteria (10 SS, 9 BF; median age 12.5  years (6.2-16.8  years)). All remained alive at 6.4  years median follow-up (1.2-13.7  years) after receiving chemotherapy and radiotherapy (13 focal/ventricular, four whole brain, two neuraxis), with only one progression. All had symptoms of @entity2010 at presentation with a symptom interval above one year in eight cases (42  %). Desmopressin was commenced and maintained in 16 @entity1 (84  %). The pituitary bright spot was lost in most diagnostic interpretable cases, but was appreciated in three @entity1 (18  %) who had normal serum @entity1372 values compared to 'absent' cases (p  =  0.013). For two such cases, spots remained visible until last follow-up (range 0.4-3.3  years), with one still receiving desmopressin. No case of bright spot recovery was observed following therapy. Protracted symptom intervals for @entity3438 -induced central @entity2010 may reflect poor clinical awareness. Explanations for persistence of the pituitary bright spot in symptomatic @entity1 remain elusive. Desmopressin seldom reverses the clinical features of @entity3438 -induced @entity2010 to allow discontinuation, nor does treatment cause bright spot recovery.

@entity2010 in XXXX of the suprasellar region: characteristic features and significance of the pituitary bright spot.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity4806 :: ('MESH:D063766', 'Disease') :: ['pediatric'] @entity1372 :: ('MESH:D012964', 'Chemical') :: ['sodium'] @entity4611 :: ('MESH:D010900', 'Disease') :: ['suprasellar/neurohypophyseal germinomas'] @entity3438 :: ('MESH:D018237', 'Disease') :: ['germinoma'] @entity2010 :: ('MESH:D003919', 'Disease') :: ['DI', 'diabetes insipidus']
@entity3438 :: (MESH:D018237,Disease) :: ['pediatric germinomas']
