title: Sellar Toxoplasmosis and Nonfunctioning Pituitary Adenoma.
abstract: BACKGROUND
  Sellar toxoplasmosis is associated with congenital infections or immunodeficiency. The finding of Toxoplasma bradycysts in a pituitary adenoma is very unusual.
  
  
  METHODS
  An otherwise healthy 27-year-old woman presented with secondary amenorrhea and moderately elevated prolactin levels. A macroprolactinoma was suspected on magnetic resonance imaging, and cabergoline was initiated. Although dopamine levels decreased, the tumor did not show significant shrinkage; after 2 years, transsphenoidal resection was indicated to clarify the diagnosis and to cure hyperprolactinemia. Histology showed an inactive pituitary adenoma and Toxoplasma bradycysts. Seropositivity for Toxoplasma gondii, but neither immunodeficiency nor intracerebral spread, was found. During a postoperative follow-up period of 15 months, the patient did not show any recurrence.
  
  
  CONCLUSIONS
  Sellar toxoplasmosis in conjunction with pituitary adenoma is extremely rare. Nonfunctioning lesions should be suspected in cases of sellar masses and moderate hyperprolactinemia.
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland. Electronic address: sven.berkmann@ksa.ch.
authors.forename: Sven
authors.initials: S
authors.lastname: Berkmann
authors.affiliation: Department of Pathology, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Fischer
authors.affiliation: Department of Infectious Diseases and Hospital Epidemiology, Kantonsspital Lucerne, Lucerne, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Sonderegger
authors.affiliation: Department of Internal Medicine, Kantonsspital Lucerne, Lucerne, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischli
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: Javier
authors.initials: J
authors.lastname: Fandino
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000150:complications* / Q000601:surgery; D014122:Toxoplasma; D016781:Toxoplasmosis, Cerebral / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D011388:Prolactin
keywords: Pituitary; Prolactin; Toxoplasmosis