Pituitary tuberculoma: an unusual lesion of sellar region.
Pituitary tuberculomas are extremely rare lesions, with only few cases described in the literature, usually mistaken as pituitary tumors. Its heterogeneous clinical and imaging profile preclude preoperative diagnosis which ultimately relies on the histopathological examination. We describe a 46 years old woman who presented with an episode of confusion and hypopituitarism with no evidence of systemic tuberculosis. Computed tomography (CT) showed a central calcified and enhancing sellar mass. Magnetic resonance imaging (MRI) showed a sellar mass with suprasellar extension and associated optic chiasm compression. She was submitted a craniotomy for biopsy and resection. A caseous material was found at the center of the lesion involved by a thick wall. Due to the wall adherence to the optic chiasm and the inflammatory aspects of the lesion, subtotal removal was achieved and the patient followed on anti-tuberculous and hormonal replacement therapy. Sellar tuberculomas should be considered in the differential diagnosis of sellar tumors in order to offer appropriate treatment.
Domingues
Flavio S
FS
Serviço de Neurocirurgia, Departamento de Cirurgia, Hospital Universitário Clementino Fraga Filho, Universidade federal do Rio de Janeiro, Rio de Janeiro, Brazil.
de Souza
Jorge Marcondes
JM
Chagas
Haroldo
H
Chimelli
Leila
L
Vaisman
Mario
M
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010900:Pituitary Diseases / Q000382:microbiology* / Q000601:surgery; D012658:Sella Turcica / Q000382:microbiology*; D016862:Tuberculoma, Intracranial / Q000473:pathology* / Q000601:surgery