title: Rare presentation of Wegener's granulomatosis in the pituitary gland: Case report and literature review.
abstract: BACKGROUND
  Wegener's granulomatosis (WG) is a systemic vasculitis that can affect a variety of organs including ear, nose and throat, lungs and kidneys. However WG is unusual in the pituitary and rare in the central nervous system.
  
  
  METHODS
  A 56-year-old male with likely WG presented with polyuria and polydipsia despite six months of conservative medical management. MRI scanning revealed an enlarging heterogeneously enhancing pituitary gland. Following endoscopic transsphenoidal pituitary biopsy and debulking, final tissue pathology was diagnostic for WG in the pituitary gland.
  
  
  CONCLUSIONS
  Diagnosis remains difficult but most patients present with central diabetes insipidus (CDI) as well as varying degrees of hypopituitarism on a background of disease activity in other organs. Clinical judgment needs to balance the need for invasive surgical tissue diagnosis with increasing immunosuppressive therapy.
  
  
  CONCLUSIONS
  It is important to consider this rare complication of WG to ensure timely diagnosis and management.
authors.affiliation: Department of Ear Nose and Throat Surgery, The Alfred Hospital, 55 Commercial Road, Prahran, VIC 3181, Australia. Electronic address: smbaird@iinet.net.au.
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Baird
authors.affiliation: Department of Ear Nose and Throat Surgery, The Alfred Hospital, 55 Commercial Road, Prahran, VIC 3181, Australia. Electronic address: upasna.pratap@gmail.com.
authors.forename: Upasna
authors.initials: U
authors.lastname: Pratap
authors.affiliation: Department of Anatomical Pathology, The Alfred Hospital, 55 Commercial Road, Prahran, VIC 3181, Australia. Electronic address: c.mclean@alfred.org.au.
authors.forename: Catriona
authors.initials: C
authors.lastname: McLean
authors.affiliation: Department of Radiology, The Alfred Hospital, 55 Commercial Road, Prahran, VIC 3181, Australia. Electronic address: c.law@alfred.org.au.
authors.forename: Candice P
authors.initials: CP
authors.lastname: Law
authors.affiliation: Department of Neurosurgery, The Alfred Hospital,55 Commercial Road, Prahran, VIC 3181, Australia. Electronic address: n.maartens@alfred.org.au.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Maartens
keywords: Case report; Central diabetes insipidus; Pituitary gland; Wegener’s granulomatosis