Giant-cell granulomatous hypophysitis: a distinct clinicopathological entity

Abstract

Idiopathic giant-cell granulomatous hypophysitis is a chronic inflammatory disorder of the pituitary gland. It presents clinically as a sellar mass lesion with pituitary insufficiency and/or hyperprolactinemia, and is radiologically indistinguishable from a pituitary tumor. In most of the previously reported cases the documentation of the disorder has been limited to autopsy tissue. Only a few cases documented by biopsy have been recorded. Four cases are presented here with radiological, endocrinological, and surgical findings. The appropriately documented cases collected from the literature and the present series are reviewed and the incidence, patterns of clinical and radiological presentation, and operative management of this disorder are discussed. This entity should be considered when evaluating patients with a pituitary mass and evidence of hypopituitarism and hyperprolactinemia.

Primary granulomatous hypophysitis: a case report and literature review

“…Imaging appearances of the three primary hypophysitis types are very similar. The striking CT features are an intrasellar mass with cystic areas and ring enhancement [12][13][14]. Currently, MRI plays a crucial role in the diagnosis of primary hypophysitis because it has distinct advantage over CT for imaging the pituitary and sellar regional lesions.…”

Symptomatic Rathke's Cleft Cyst Coexisting with Central Diabetes Insipidus and Hypophysitis: Case Report.

“…Seven years after the surgery, MRI showed no recurrence, and the pituitary function test data were almost within normal limits, but the diabetes insipidus had persisted ( Table 2). [12,13]. Tuberculosis, syphilis, sarcoidosis and other systemic granulomatous diseases have also been considered as etiological factors in pituitary granulomas [14][15][16][17].…”

Granulomatous hypophysitis: experience with eight surgical cases of a single center

“…The majority of cases are primary, and are characterized by a predominance of epithelioid histiocytes and multinucleated giant cells. Secondary hypophysitis may occur in patients with systemic conditions, such as Takayasu's disease [17], ruptured intrasellar Rathke's cleft cyst [1,11], Wegener's granulomatosis [4], Crohn's disease [3], thyroiditis and lymphocytic adrenalitis [13]. Pressure symptoms and visual impairment may arise from the development of a sellar mass lesion, mass effect, and involvement of the pituitary stalk, ensuing pituitary destruction may result in endocrine dysfunction.…”