Inflammatory myofibroblastic tumor of the pituitary: A case report

Abstract

Introduction: Inflammatory myofibroblastic tumor (IMT), a subtype of inflammatory pseudotumor, is a rare cause of nonneoplastic sellar mass. IMTs have been reported in various anatomical locations of the body, but their presence in the Central Nervous System (CNS), especially in the pituitary gland, is rare. The objective of our case report is to analyze the basis of their mimicry, discuss their differential diagnosis, and review the literature related to inflammatory pseudotumors of the pituitary. Case presentation: A 45-year-old male presented in our hospital with chief complaints of severe headache since two months ago and blurring of vision since two weeks ago. On investigation, Magnetic Resonance Imaging (MRI) revealed a pituitary macroadenoma, which was compressing the optic chiasma and encasing the left internal carotid artery. The patient underwent endonasal endoscopic transsphenoidal excision of the pituitary lesion and became asymptomatic in the postoperative period. Histopathology reported the presence of spindle-shaped cells, inflammatory cells, respiratory epithelium lined tissue, and areas of necrosis suggestive of an inflammatory myofibroblastic tumor. Conclusion:In the following communication, we discuss this esoteric pseudotumor of the pituitary and its peculiarities in diagnosis and management as it can easily disguise itself as a pituitary macroadenoma on radiological investigations, thus hoodwinking the physician of its actual pathology. We also review the literature to perceive the best management protocols and prognostic factors by drawing parallels with IMT in other parts of the CNS. The differential diagnosis of inflammatory myofibroblastic tumors of the CNS is difficult and relies mainly on histological analysis.