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Sellar Toxoplasmosis and Nonfunctioning Pituitary Adenoma
Sven Berkmann1, Ingeborg Fischer2, Beat Sonderegger3
1Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.
World Neurosurgery
|June 1, 2015
Summary
Sellar toxoplasmosis, a rare infection, was found in a pituitary adenoma in an otherwise healthy woman. This unusual finding suggests considering nonfunctioning lesions in sellar masses with moderate hyperprolactinemia.
Area of Science:
- Endocrinology
- Infectious Diseases
- Neuropathology
Background:
- Sellar toxoplasmosis is typically linked to congenital infections or compromised immune systems.
- The presence of Toxoplasma bradycysts within a pituitary adenoma is an exceptionally rare occurrence.
Observation:
- A 27-year-old woman presented with secondary amenorrhea and elevated prolactin levels, initially suspected as a macroprolactinoma.
- Despite treatment with cabergoline, the pituitary tumor showed minimal shrinkage, necessitating surgical resection for diagnosis and hyperprolactinemia management.
Findings:
- Histopathological examination revealed an inactive pituitary adenoma containing Toxoplasma bradycysts.
- The patient was seropositive for Toxoplasma gondii but had no signs of immunodeficiency or intracranial spread.
Implications:
- This case highlights the extreme rarity of coexisting sellar toxoplasmosis and pituitary adenoma.
- Nonfunctioning sellar masses should be considered in patients with moderate hyperprolactinemia, even in the absence of apparent immunodeficiency.
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