Granulomatosis with polyangiitis presenting as a pituitary lesion

Christou, Miss Louise; Thomas, Ajit; Dutta, Shouma; Shaw, Simon; Jose, Biju

doi:10.12968/hmed.2017.78.4.234

Cited by 5 publications

(1 citation statement)

References 3 publications

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“…Pituitary lesions are exceedingly uncommon; in a study of 819 patients with GPA, only 9 (1.1%) had pituitary involvement [3]. We identified 57 reported cases of GPA with pituitary involvement in the literature to date, with diabetes insipidus presenting often and panhypopituitarism presenting as a less common complication [3][4][5][6][7][8]. Here we describe the case of a young woman with GPA who presented with symptoms initially suggestive of meningitis, but on further evaluation had hypopituitarism and was found to have an enlarging pituitary mass caused by GPA.…”

Section: Introductionmentioning

confidence: 99%

Granulomatosis with Polyangiitis Manifesting as a Symptomatic Sellar Mass in a Young Woman

Gadani

Nadgir

Windon

et al. 2019

Cureus

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A pituitary mass is a rare and poorly understood complication of granulomatosis with polyangiitis (GPA). Here we describe the case of a young woman with GPA who presented with signs and symptoms initially suggestive of meningitis but was ultimately found to have hypopituitarism and an enlarging sellar mass. She underwent transsphenoidal biopsy, which revealed an abundance of sterile inflammation and necrosis consistent with GPA-related inflammation. This case demonstrates a rare complication of GPA, i.e., a pituitary mass, initially mimicking meningitis. GPA-related pituitary involvement has an unknown pathogenesis and can have debilitating long-term consequences including chronic hypopituitarism and vision impairment, highlighting the need for further research.

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Section: Introductionmentioning

confidence: 99%

Granulomatosis with Polyangiitis Manifesting as a Symptomatic Sellar Mass in a Young Woman

Gadani

Nadgir

Windon

et al. 2019

Cureus

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Pituitary dysfunction in granulomatosis with polyangiitis

et al. 2019

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Very Unusual Sellar/Suprasellar Region Masses: A Review

Abushamat

Kerr

Lopes

et al. 2019

Journal of Neuropathology &Amp; Experimental Neurology

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The cause of sellar region masses in large retrospective series is overwhelmingly pituitary adenomas (84.6%), followed by craniopharyngiomas (3.2%), cystic nonneoplastic lesions (2.8%), inflammatory lesions (1.1%), meningiomas (0.94%), metastases (0.6%), and chordomas (0.5%) (1). While other rare lesions were also identified (collectively 6.0%), single unusual entities in the above-cited series numbered <1–2 examples each out of the 4122 cases, underscoring their rarity. We searched our joint files for rare, often singular, sellar/suprasellar masses that we had encountered over the past several decades in our own specialty, tertiary care specialty pituitary center practices. Cases for this review were subjectively selected for their challenging clinical and/or histological features as well as teaching value based on the senior authors' (MBSL, BKD) collective experience with over 7000 examples. We excluded entities deemed to be already well-appreciated by neuropathologists such as mixed adenoma-gangliocytoma, posterior pituitary tumors, metastases, and hypophysitis. We identified examples that, in our judgment, were sufficiently unusual enough to warrant further reporting. Herein, we present 3 diffuse large cell B cell pituitary lymphomas confined to the sellar region with first presentation at that site, 2 sarcomas primary to sella in nonirradiated patients, and 1 case each of granulomatosis with polyangiitis and neurosarcoidosis with first presentations as a sellar/suprasellar mass. Other cases included 1 of chronic lymphocytic leukemia within a gonadotroph adenoma and 1 of ectopic nerve fascicles embedded within a somatotroph adenoma, neither of which impacted patient care. Our objective was to share these examples and review the relevant literature.

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Granulomatosis with polyangiitis presenting as a pituitary lesion

Cited by 5 publications

References 3 publications

Granulomatosis with Polyangiitis Manifesting as a Symptomatic Sellar Mass in a Young Woman

Granulomatosis with Polyangiitis Manifesting as a Symptomatic Sellar Mass in a Young Woman

Pituitary dysfunction in granulomatosis with polyangiitis

Very Unusual Sellar/Suprasellar Region Masses: A Review

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