Suprasellar tubercular abscess presenting as panhypopituitarism: A common lesion in an uncommon site with a brief review of literature

Dutta, Pinaki; Bhansali, Anil; Singh, Paramjeet; Bhat, Mohd Shafi

doi:10.1007/s11102-006-5420-2

Cited by 36 publications

(24 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiologically (as in our patient), the tumour is usually sellar and suprasellar, being isointense on T1-weighted images and hyperintense on T2-weighted sequences (5). Pituitary stalk thickening is often noted on MR scans (6) (7). The clinical and radiological features of these lesions mimic a typical pituitary adenoma.…”

Section: Discussionsupporting

confidence: 53%

Tuberculosis in the pituitary fossa: a common pathology in an uncommon site

Majumdar

Barnard

Ramachandra

et al. 2014

Endocrinology, Diabetes &Amp; Metabolism Case Reports

View full text Add to dashboard Cite

SummaryTuberculosis (TB) is an important cause of mortality and morbidity across the world. In 2–5% of all cases of systemic TB, the C is affected, with lesions reported in the meninges, cortex and ventricles. Intrasellar tuberculomas, however, are extremely rare. We report the interesting case of a young female patient who presented with secondary hypothyroidism and hyperprolactinaemia. She was treated successfully for pituitary TB. We also highlight and discuss some interesting (and hitherto unreported) endocrine issues. Radiological and histological features and treatment of pituitary TB are discussed using this case as an example.Learning points Intrasellar TB continues to be a rare presentation, but incidence and prevalence are expected to grow with increasing numbers of multidrug-resistant TB and shrinking geographical boundaries across the world.Pituitary TB can present with features of a typical adenoma, but has certain radiological and histological features that help to differentiate from an adenoma.Patients can present with a variety of endocrine abnormalities at different times.The presence of an intrasellar mass in individuals at a high risk of developing TB, or with a previous history of systemic TB, should prompt the diagnosis of pituitary TB. In such individuals, it may be worth considering a trial of anti-tuberculous therapy, before considering surgery.

show abstract

Section: Discussionsupporting

confidence: 53%

Tuberculosis in the pituitary fossa: a common pathology in an uncommon site

Majumdar

Barnard

Ramachandra

et al. 2014

Endocrinology, Diabetes &Amp; Metabolism Case Reports

View full text Add to dashboard Cite

show abstract

“…A prolonged course (9–12 months), such as that used for meningeal and central nervous system TB, may be a reasonable approach. Surgical intervention is usually reserved for diagnostic or decompressive purposes [8,11]. Hormone replacement therapy may be needed if pituitary functions are affected.…”

Section: Discussionmentioning

confidence: 99%

Primary Pituitary Tuberculosis Revisited

et al. 2017

View full text Add to dashboard Cite

Patient: Female, 45Final Diagnosis: Primary pituitary tuberculosisSymptoms: Headache • vomiting • vomitingMedication: —Clinical Procedure: Pituitary biospySpecialty: Endocrinology and MetabolicObjective:Rare diseaseBackground:Primary pituitary tuberculosis (in absence of other organ involvement and constitutional symptoms) is an extremely rare disease with total reported cases in the literature fewer than a hundred. Misdiagnosis as pituitary adenoma is common and late diagnosis can result in a permanent endocrine dysfunction and/or long-term neurologic sequelae.Case Report:We report on the case of a middle-aged woman who presented with severe headache and left third cranial nerve palsy. Magnetic resonance imaging (MRI) revealed a large pituitary tumor invading the left cavernous sinus. The case was initially misdiagnosed as pituitary adenoma. A pituitary biopsy was performed and was suggestive of pituitary tuberculosis. Extensive radiologic investigations did not reveal any evidence of other organ involvement by tuberculosis. She was successfully treated with anti-tuberculous medications.Conclusions:In areas with a high pre-test probability of tuberculosis, pituitary tuberculosis should be included in the differential diagnosis of pituitary tumors in order to avoid unnecessary surgical interventions. Besides being the first histologically-proven primary pituitary tuberculosis case reported from Qatar, the current case is unique in that extensive radiologic investigations did not reveal any evidence of other systemic or pulmonary tuberculosis.

show abstract

“…Surgery is not usually indicated, except for obtaining biopsies to confirm diagnosis, as these lesions tend to resolve with appropriate antituberculous treatment (ATT) is mandatory in all patients even if the lesion is removed surgically 9. There is no consensus regarding the type of antitubercular regimen and duration of the treatment as the experience with tuberculomas of pituitary is limited.…”

Section: Discussionmentioning

confidence: 99%

Pituitary tuberculoma with subsequent drug-resistant tuberculous lymphadenopathy: an uncommon presentation of a common disease

Antony

Dasgupta²,

Chacko

et al. 2017

BMJ Case Reports

View full text Add to dashboard Cite

We report a case of pituitary tuberculosis which presented as a non-functioning pituitary macroadenoma, and subsequently developed multidrug-resistant tuberculous lymphadenopathy. Pituitary tuberculosis continues to be a rare presentation of tuberculosis, but incidence and prevalence are expected to grow with increasing numbers of multidrug-resistant tuberculosis. Isolated pituitary tuberculosis is rare. Tuberculosis should be considered in the differential diagnosis in evaluation of a sellar mass.

show abstract

Suprasellar tubercular abscess presenting as panhypopituitarism: A common lesion in an uncommon site with a brief review of literature

Cited by 36 publications

References 18 publications

Tuberculosis in the pituitary fossa: a common pathology in an uncommon site

Tuberculosis in the pituitary fossa: a common pathology in an uncommon site

Primary Pituitary Tuberculosis Revisited

Pituitary tuberculoma with subsequent drug-resistant tuberculous lymphadenopathy: an uncommon presentation of a common disease

Contact Info

Product

Resources

About