Imagerie des tuberculomes intra-sellaires : rapport de 2 cas

Harzallah, L.; Migaw, H.; Harzallah, F.; Kraiem, C

doi:10.1016/s0003-4266(04)95673-9

Cited by 8 publications

(2 citation statements)

References 6 publications

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“…On the other hand, in the presence of caseous necrosis, the tuberculoma appears hypointense in T1WI with peripheral enhancement. This appearance is rare and non-specific and can be observed in any pituitary abscess [ 18 ]. In our case, the MRI also showed a thickening of the pituitary stalk.…”

Section: Discussionmentioning

confidence: 99%

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A pituitary mass is not always an adenoma: A rare case of pituitary tuberculoma in an adolescent

Derbel,

Tahri,

Assarrar

et al. 2024

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

“…This radiological sign is often present but is far from being specific of tuberculosis, it may be find in other granulomatosis [ 17 ]. Indeed, this sign allows us to suspect the inflammatory origin of the lesion such as tuberculosis, sarcoidosis, histiocytic or lymphocytic involvement [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

A pituitary mass is not always an adenoma: A rare case of pituitary tuberculoma in an adolescent

Derbel,

Tahri,

Assarrar

et al. 2024

International Journal of Surgery Case Reports

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Necrotizing Granulomatous Hypophysitis Presenting as a Sellar Mass

et al. 2011

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We report the case of a 45-year-old Colombian female with a 3-month history of headache, anorexia, fatigue, and diplopia in addition to left facial nerve palsy 2 weeks prior to presentation. On examination, visual fields and fundi were normal, but left abducens and facial nerve palsies were noted. An MRI scan disclosed a sellar mass with suprasellar but neither parasellar nor retrosellar extension. The mass was interpreted as a pituitary tumor and resected via the transsphenoidal approach. Histologic examination revealed necrotizing granulomas in a background of normal pituitary gland tissue. The differential diagnosis includes tuberculosis, sarcoidosis, fungal infection, syphilis, granulomatous autoimmune hypophysitis, Langerhans cell histiocytosis, and Erdheim-Chester disease. Staining for tubercle bacilli (acid fast and fite) as well as for fungi (GMS) was negative and PCR for mycobacteria showed the same result. Postoperative empiric treatment with antituberculous medication resulted in resolution of the cranial nerve palsies within a 1 month. The diagnosis of inflammatory/infectious granulomatous hypophysitis can be difficult to diagnose preoperatively and occasionally even postoperatively. A high index of suspicion should be maintained especially in those patients with a history of a systemic granulomatous disease or in regions endemic in granulomatous infectious diseases.

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