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Pituitary tuberculosis in the pediatric population: a systematic review and case report
Agata Gierlotka1, Ryszard Sordyl2, Ireneusz Bielecki3
1Department of Pediatric Otolaryngology, Head and Neck Surgery, the Medical University of Silesia in Katowice, Saint John Paul II Upper Silesian Children's Health Center, Ul. Medyków 16, Katowice, 40-752, 0048322071965, Poland. agierlotka@gczd.katowice.pl.
Insights
Pediatric pituitary tuberculosis is a diagnostic challenge that mimics pituitary adenoma. Early diagnosis and treatment are crucial to prevent permanent endocrine dysfunction and may require lifelong hormone replacement.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Neuroscience
Background:
- Tuberculosis remains a significant global health issue, even with medical advancements.
- Pituitary tuberculosis, specifically intrasellar tuberculoma, poses diagnostic challenges due to its resemblance to pituitary adenomas.
- Early recognition is vital to prevent long-term complications.
Purpose of the Study:
- To identify and evaluate management strategies for pituitary tuberculosis in children.
- To review existing literature and present a case study on pediatric pituitary tuberculosis.
Main Methods:
- A systematic literature review was conducted using PubMed, Cochrane Library, and ScienceDirect.
- Keywords included "pituitary gland," "tuberculosis," "sellar tuberculoma," "children," "pediatric," and "adolescent."
- Publications from 2014-2025 were analyzed, supplemented by a new case presentation.
Main Results:
- Eight publications reporting on 8 pediatric cases of sellar/suprasellar tuberculosis were included.
- A total of 9 patients (6 female, 3 male) with a mean age of 10.6 years were analyzed.
- Clinical data, including symptoms, endocrine issues, and imaging findings, were examined.
Conclusions:
- Pituitary tuberculosis requires inclusion in the differential diagnosis for sellar masses, despite potential lack of typical clinical or radiological signs.
- A biopsy via a minimally invasive transsphenoidal approach is the gold standard for diagnosis.
- Delayed diagnosis can result in irreversible endocrine dysfunction, necessitating regular monitoring and potential lifelong hormone replacement therapy.
Purpose:
This review aims to identify and evaluate the management options for pituitary tuberculosis in the pediatric population.
Methods:
The study was conducted based on a comprehensive literature review using the PubMed, Cochrane Library, and ScienceDirect electronic databases. The following keywords were used: pituitary gland and tuberculosis or sellar tuberculoma and children or pediatric or adolescent. We limited the results to publications from 2014 to 2025. The study is a systematic review supplemented by a new case presentation.
Results:
Eight publications containing reports of 8 children with sellar/suprasellar tuberculosis were included to the review. The clinical data, including sex, age at diagnosis, country of origin, symptoms, endocrine disturbances, intracranial location, MRI findings, and treatment, were analyzed. The study was supplemented by a new case presentation in our department. Out of the 9 patients, 6 were female and 3 were male. The mean age was 10.6 years (with the range between 2 and 17 years).
Conclusions:
Despite undeniable advances in medicine, the development of diagnostic and therapeutic methods, and the use of prophylactic vaccination, BCG (Bacillus Calmette-Guérin) tuberculosis is still a huge healthcare problem. Intrasellar tuberculoma presents a diagnostic challenge for clinicians since it mimics a pituitary adenoma and, therefore, should be included in the differential diagnosis. The lack of clinical and radiological data on tuberculosis, does not rule out the diagnosis of pituitary tuberculosis. The gold standard for the diagnosis of pituitary tumors is a biopsy, performed by a minimally invasive transsphenoidal approach. A delayed diagnosis may lead to permanent endocrine dysfunction. Regular follow-ups are crucial for evaluating the patient's hormone profile and may require lifelong hormone replacement.
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