Hypophysitis secondary to ruptured Rathke's cyst mimicking neurosarcoidosis.
Hypophysitis secondary to a ruptured Rathke's cyst is rare. We describe a 53-year-old female who presented with headache and subsequently developed aseptic meningitis and panhypopituitarism. MRI findings and concomitant cardiac arrhythmia and peripheral vasculitis led to a provisional diagnosis of neurosarcoidosis. There were no respiratory manifestations of sarcoidosis. Improvement was noted with empirical treatment with steroids. Pituitary biopsy was undertaken to confirm the diagnosis prior to treatment with long-term immunosuppression for putative neurosarcoidosis. The biopsy revealed lymphocytic hypophysitis secondary to a ruptured Rathke's cyst. This report highlights a rare pathology and the importance of a tissue diagnosis before undertaking non-surgical management of a pituitary mass.
Janeczko
Cassandra
C
Department of Neurology, Beaumont Hospital, P.O. Box 1297, Beaumont Road, Dublin 9, Ireland. cejaneczko@hotmail.com
McHugh
John
J
Rawluk
Daniel
D
Farrell
Michael
M
Brennan
Paul
P
Delanty
Norman
N
D017542:Aneurysm, Ruptured / Q000134:cerebrospinal fluid / Q000150:complications*; D020863:Central Nervous System Cysts / Q000134:cerebrospinal fluid / Q000150:complications*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010900:Pituitary Diseases / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000473:pathology; D014056:Tomography, X-Ray / Q000379:methods