title: Hypophysitis secondary to ruptured Rathke's cyst mimicking neurosarcoidosis.
abstract: 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.
authors.affiliation: Department of Neurology, Beaumont Hospital, P.O. Box 1297, Beaumont Road, Dublin 9, Ireland. cejaneczko@hotmail.com
authors.forename: Cassandra
authors.initials: C
authors.lastname: Janeczko
authors.forename: John
authors.initials: J
authors.lastname: McHugh
authors.forename: Daniel
authors.initials: D
authors.lastname: Rawluk
authors.forename: Michael
authors.initials: M
authors.lastname: Farrell
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: Norman
authors.initials: N
authors.lastname: Delanty
mesh_terms: 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