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Sarcoidosis within a pituitary adenoma
M R Rubin1, J N Bruce, A G Khandji
1Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Pituitary
|July 26, 2002
Summary
This case report details a man with a pituitary adenoma who was diagnosed with neurosarcoidosis. The condition mimicked other causes of hypercalcemia and was successfully treated with corticosteroids.
Area of Science:
- Endocrinology
- Neurology
- Pathology
Background:
- Neurosarcoidosis, a rare manifestation of sarcoidosis, can affect the pituitary gland, presenting diagnostic challenges.
- Pituitary masses can cause various endocrine dysfunctions and neurological symptoms.
Observation:
- A 54-year-old man presented with headaches, hypercalcemia, and a pituitary mass on CT scan.
- Laboratory results indicated non-PTH-mediated hypercalcemia and hypogonadism.
- MRI revealed a large pituitary mass compressing surrounding structures.
Findings:
- Pathological examination of the resected pituitary adenoma showed granulomas consistent with sarcoidosis.
- Transbronchial biopsy confirmed non-caseating granulomas, and elevated ACE levels supported the diagnosis.
- The patient experienced resolution of hypercalcemia after treatment with corticosteroids.
Implications:
- This case highlights the importance of considering sarcoidosis in the differential diagnosis of pituitary masses and hypercalcemia.
- It is the first reported instance of sarcoidosis occurring within a pituitary adenoma.
- Early diagnosis and treatment of neurosarcoidosis are crucial for managing endocrine and neurological complications.