[Isolated hypophyseal tuberculoma: often mistaken]

Area of Science:

• Endocrinology
• Infectious Diseases
• Radiology

Background:

• Hypophyseal tuberculoma is an exceptionally rare condition affecting the pituitary gland.
• Diagnosis is often challenging due to non-specific radiologic features.

Observation:

• Magnetic resonance imaging (MRI) can reveal a pituitary mass with variable signal intensity, indicative of caseous necrosis.
• Thickening of the pituitary stalk is a potential indicator of tuberculosis, prompting further investigation for disseminated disease.

Findings:

• This report details a unique case of hypophyseal tuberculoma occurring in the absence of any other concurrent tuberculosis infection.
• The lack of systemic signs of tuberculosis complicated the diagnostic process, despite characteristic MRI findings.

Implications:

• This case highlights the importance of considering hypophyseal tuberculoma even in atypical presentations.
• Recognizing subtle imaging findings, like pituitary stalk thickening, is crucial for timely diagnosis and management of this rare condition.