Pituitary Tuberculosis - A Rare Case Report

Abstract

Tuberculosis is an infectious disease primarily affecting lungs and also involves any body organ. Intracranial tuberculosis constitutes about 0.15-5% of all intracranial space-occupying lesions. Pituitary gland as primary site for tuberculosis is very rare. Delayed diagnosis and treatment can result in permanent endocrine dysfunction. Here we present a case in a 44-year-old female presented to the hospital with complaints of progressive worsening headache, left eye pain, and blurred vision for 6 months. Patient was evaluated and radiological workup was done. MRI brain with contrast showed enhancing mass lesion of 1.7x1.4 cm arising from Sella with mass effect on optic chiasma and it was radiologically diagnosed as pituitary adenoma. A biopsy from the pituitary region was obtained and histopathological examination was done. Microscopic examination revealed pituitary gland parenchyma showing well-formed epithelioid granulomas consisting of epithelioid cells, Langhans type of giant cells, and chronic inflammatory cells along with foci of caseous necrosis. The case was finally diagnosed as pituitary tuberculoma. Keywords: Tuberculosis, granuloma, space-occupying lesion, pituitary gland.