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Related Experiment Video

Updated: Jun 4, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Necrotizing granulomatous hypophysitis presenting as a sellar mass.

Sahar Al-Haddad¹, Rafael Fandino, Bernd W Scheithauer

¹Department of Laboratory Medicine, St Michael's Hospital, University of Toronto, 30 Bond St, Toronto, ON M5B 1W8, Canada. al-haddads@smh.ca

Endocrine Pathology

|February 9, 2011

Summary

A pituitary mass initially suspected to be a tumor was found to be granulomatous hypophysitis. Treatment with antituberculous medication resolved cranial nerve palsies, highlighting the importance of considering infectious causes.

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Last Updated: Jun 4, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Area of Science:

Endocrinology
Neurology
Pathology

Background:

Cranial nerve palsies and hypophyseal symptoms can indicate sellar masses.
Pituitary tumors are a common cause, but inflammatory and infectious etiologies must be considered.

Purpose of the Study:

To report a case of granulomatous hypophysitis mimicking a pituitary tumor.
To emphasize the diagnostic challenges and treatment outcomes.

Main Methods:

Case presentation of a 45-year-old female with headache, fatigue, and cranial nerve palsies.
Magnetic Resonance Imaging (MRI) revealing a sellar mass.
Transsphenoidal resection and histopathological examination.
Postoperative empiric treatment with antituberculous medication.

Main Results:

Histology showed necrotizing granulomas, inconsistent with a typical pituitary tumor.
Infectious and autoimmune granulomatous diseases were considered in the differential diagnosis.
Antituberculous treatment led to complete resolution of cranial nerve palsies within one month.

Conclusions:

Granulomatous hypophysitis can present as a sellar mass with neurological deficits.
Preoperative and even postoperative diagnosis can be challenging.
A high index of suspicion is crucial, especially in endemic regions for granulomatous infections or in patients with systemic granulomatous disease.