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Reversible hypopituitarism with pituitary tuberculoma
Keiji Tanimoto1, Ayumi Imbe, Kanako Shishikura
1Department of Internal Medicine (I), Osaka Medical College, Japan.
Internal Medicine (Tokyo, Japan)
|May 20, 2015
Summary
Pituitary tuberculoma, a rare condition, can cause hormone deficiencies and present as a sellar mass. Effective treatment with antituberculous drugs led to complete recovery and normalization of pituitary function in this case.
Area of Science:
- Endocrinology
- Infectious Diseases
- Neurology
Background:
- Pituitary tuberculomas are rare intracranial tuberculomas.
- They can present with sellar/suprasellar masses and pituitary dysfunction.
Observation:
- A 50-year-old woman presented with headache, nausea, and hormonal deficiencies (GH, LH, FSH, TSH).
- MRI revealed a sellar/suprasellar mass with heterogeneous enhancement and a thickened pituitary stalk.
- Pathology showed granulomas with necrosis and Langhans giant cells; TB tests were positive.
Findings:
- The patient was diagnosed with pituitary tuberculoma.
- Treatment with antituberculous drugs resulted in the disappearance of the pituitary tuberculoma.
- Pituitary hormone function normalized post-treatment.
Implications:
- This case highlights the importance of considering tuberculosis in the differential diagnosis of sellar masses.
- Early diagnosis and appropriate antituberculous therapy can lead to favorable outcomes and reversal of pituitary dysfunction.
- Pituitary tuberculoma is a treatable cause of hypopituitarism.
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