Panhypopituitarism revealing sellar tuberculoma

Pituitary tuberculoma with panhypopituitarism masquerading as a pituitary adenoma

“…Based on the available literature, it commonly affects women of mean age of 23.6, but the present case was an adult male 7 . Mostly, it occurs as a part of systemic infection followed by hematogenous spread, but few cases have been reported as an isolated lesion only 1,8 . The present case was also an isolated sellar tubercular lesion without any active pulmonary tuberculosis.…”

“…7 Mostly, it occurs as a part of systemic infection followed by hematogenous spread, but few cases have been reported as an isolated lesion only. 1,8 The present case was also an isolated sellar tubercular lesion without any active pulmonary tuberculosis.…”

“…5 However, thickening of the pituitary stalk may be seen in many other conditions, including sarcoidosis, lymphocytic hypophysitis, syphilis, and lymphoma. 8 Hence, a histopathological examination of pituitary lesions demonstrating epithelioid cell granulomas, Langhans giant cells, and necrosis will only confirm the diagnosis and guide clinicians for initiation of antitubercular therapy.…”

“…There are only subtle findings differentiating a tubercular abscess from an adenoma on contrast‐enhanced MRI, which includes peripheral contrast enhancement, adjacent meningeal enhancement, and thickening and enhancement of the pituitary stalk in the former one 5 . However, thickening of the pituitary stalk may be seen in many other conditions, including sarcoidosis, lymphocytic hypophysitis, syphilis, and lymphoma 8 . Hence, a histopathological examination of pituitary lesions demonstrating epithelioid cell granulomas, Langhans giant cells, and necrosis will only confirm the diagnosis and guide clinicians for initiation of antitubercular therapy.…”