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Intrasellar Tuberculosis Presenting as Pituitary Apoplexy: A Case Report
Shankar Ayyappan Kutty1, Naemieh Mohammad Kamel Aljasem2, Anagha Shankar3
1Neurosciences, NMC Specialty Hospital, Abu Dhabi, ARE.
Cureus
|January 9, 2025
Summary
Pituitary apoplexy symptoms can mimic other rare conditions like tuberculosis. Intrasellar tuberculoma is a crucial differential diagnosis, especially in endemic areas or immunocompromised individuals.
Area of Science:
- Neuroscience
- Infectious Diseases
- Endocrinology
Background:
- Pituitary apoplexy, often caused by pituitary adenoma, presents with sudden headache and ophthalmoplegia.
- Mimicking conditions necessitate a high index of suspicion for accurate diagnosis.
- Tuberculosis (TB) can rarely present as a pituitary mass.
Observation:
- A 37-year-old male from India presented with symptoms consistent with pituitary apoplexy.
- Imaging revealed intra- and supra-sellar tuberculosis (TB).
- The patient also exhibited constitutional symptoms.
Findings:
- Surgical intervention followed by anti-tuberculous therapy led to clinical improvement.
- Intrasellar tuberculoma successfully mimicked pituitary apoplexy clinically and radiologically.
- This case highlights TB as a treatable mimic of pituitary apoplexy.
Implications:
- Intrasellar tuberculoma should be considered in the differential diagnosis of pituitary apoplexy.
- High index of suspicion is crucial for patients from TB-endemic regions or those who are immunocompromised.
- Early diagnosis and treatment of CNS TB can prevent significant morbidity.
