Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(01): 141-143
DOI: 10.4103/ajns.AJNS_371_20
Case Report

Pituitary tuberculoma masquerading as a pituitary adenoma: Interesting case report and review of literature

Blessy Prabha
1   Department of Otorhinolaryngology, Manipal Hospitals Whitefield, Bengaluru, Karnataka
,
Vijay Rangachari
1   Department of Otorhinolaryngology, Manipal Hospitals Whitefield, Bengaluru, Karnataka
,
Venugopal Subramaniam
2   Department of Neurosurgery, Manipal Hospitals Whitefield, Bengaluru, Karnataka
,
Thottatil Gopan
3   Department of Endocrinology, Manipal Hospitals Whitefield, Bengaluru, Karnataka
,
Vidya Baliga
4   Department of Histopathology, Manipal Hospitals Whitefield, Bengaluru, Karnataka
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

We present a rare case of a pituitary tuberculoma masquerading as pituitary adenoma with pituitary apoplexy-like presentation in a 31-year-old female, who had symptoms suggestive of acute secondary adrenal insufficiency with secondary amenorrhea. After initial evaluation which was suggestive of pituitary adenoma, she underwent endoscopic transnasal pituitary tumor excision. Histopathology revealed features of pituitary tuberculoma. She was subsequently started on four drug anti-tubercular therapy and is on follow-up. Although uncommon, tuberculomas, especially in the pituitary gland, are known for behaving like pituitary adenomas, by impairment of pituitary hormonal function and by exerting pressure effects on surrounding vital intracranial structures. Diagnostic challenges, treatment modality, and literature review are presented in this case report. Pituitary tuberculoma even though a rare entity should be borne in mind as a differential diagnosis in a patient manifesting with pituitary apoplexy-like syndrome.

Key-words:

Anti-tubercular therapy - hormone replacement - pituitary tuberculoma - sellar adenoma

Financial support and sponsorship

Nil.




Publication History

Received: 28 July 2020

Accepted: 06 October 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Ayele BA, Abdinasir W, Abate B, Abdi T. Sellar tuberculoma: A rare presentation in a 30-year-old Ethiopian woman: Case report. Afr J Neurol Sci 2019;38:50-3.
  • 2 Mascarenhas JV, Ayyar SV. Tuberculosis of the sella masquerading as pituitary adenoma. J Clin Sci Res 2013;2:42-4.
  • 3 Srisukh S, Tanpaibule T, Kiertiburanakul S, Boongird A, Wattanatranon D, Panyaping T, et al. Pituitary tuberculoma: A consideration in the differential diagnosis in a patient manifesting with pituitary apoplexy-like syndrome. IDCases 2016;5:63-6.
  • 4 Coleman CC, Meredith JM. Diffuse tuberculosis of the pituitary gland stimulating tumor, with postoperative recovery. Arch Neur Psych 1940;44:1076-85.
  • 5 Kim SH, Kim DG. Sellar tuberculoma mimicking pituitary adenoma. J. Korean Neurosurg Soc 2003;34:245-8.
  • 6 Rajasekaran S, Vanderpump M, Baldeweg S, Drake W, Reddy N, Lanyon M, et al. UK guidelines for the management of pituitary apoplexy. Clin Endocrinol (Oxf) 2011;74:9-20.
  • 7 Deogaonkar M, De R, Sil K, Das S. Pituitary tuberculosis presenting as pituitary apoplexy. Int J Infect Dis 2006;10:338-9.
  • 8 Gupta PK, Pandey S, Pandey D. Pituitary tuberculoma: An uncommon pathology. Indian J Neurosurg 2020. DOI: https://doi.org/10.1055/s-0039-3401334.
  • 9 Manghani DK, Gaitonde PS, Dastur DK. Pituitary tuberculoma–a case report. Neurol India 2001;49:299-301.
  • 10 Singh S. Pituitary tuberculoma: Magnetic resonance imaging. Neurol India 2003;51:548-50.