Pituitary Tuberculosis Research Articles

Panhypopituitarism revealing pituitary tuberculosis: a case report

Panhypopituitarism revealing pituitary tuberculosis: a case report

Primary pituitary tuberculosis: A rare clinical entity.

Primary pituitary tuberculosis: A rare clinical entity.

Sellar Tuberculosis Mimicking Pituitary Adenoma

Tuberculosis of central nervous system accounts for only 1% of tuberculosis cases worldwide, of which pituitary is an extremely unusual site. We report a case of pituitary tuberculosis in a 29-year-old female presenting with complains of headache and diminished vision on right eye. It was misdiagnosed as pituitary adenoma on radiology. Biopsy showed epithelioid granulomas, langhans giant cells and caseous necrosis. Ziehl nelseen stain showed presence of acid fast bacilli confirming the tubercular etiology. Therefore, histology remains the mainstay for diagnosis of these lesions. Early diagnosis and prompt use of antitubercular drugs results in good outcome.

Pituitary stalk thickening in patients under 18 years of age - the most common causes and diagnostic procedures.

Pituitary stalk thickening (PST) is a rare abnormality in children, and it may be challenging due to its diverse clinical picture. The aim of the study is to summarize the data on the causes and diagnostic procedures of PST. Papers were searched in the PubMed database identifying published randomized clinical trials, reviews, systematic reviews, meta-analyses, and case reports. The most common causes of a thickened pituitary stalk in children are germ cell tumours (GCTs), Langerhans cell histiocytosis (LCH), and lymphocytic infundibulo-neurohypophysitis (LINH). Neurosarcoidosis, pituitary tuberculosis, granulomatosis, or specific inflammations were only reported in the paediatric population as case studies. PST mainly affects teenagers and is often detected with brain magnetic resonance imaging (MRI) in patients with central diabetes insipidus (CDI). It is not possible to differentiate the causes of PST with the use of the MRI image alone. Although various biochemical and oncological markers and other imaging tests are used, the diagnosis of PST remains a significant diagnostic challenge for clinicians. The final diagnosis is made based on histopathological examination. The indications for a biopsy are not uniform. Most experts, including the authors of the 2021 British consensus, recommend biopsy in the case of PST with a stalk lesion diameter ≥ 6.5-7 mm. The differential diagnosis of PST is a challenge. The diagnostic and treatment strategy should be individually adapted. Patients should be diagnosed in large clinical centres with experience in this field.

Complete third nerve oculomotor nerve palsy as initial presentation of pituitary tuberculosis

Complete third nerve oculomotor nerve palsy as initial presentation of pituitary tuberculosis

Pituitary tuberculosis: A clinical challenge

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Pituitary tuberculosis: a diagnosis not to be ignored

The first description of pituitary abscess dates back to 1914, for ten cases listed in the literature. Despite its rarity, tuberculosis pituitary abscess must be evoked in the face of a clinical picture of intracranial hypertension, pituitary hormonal dysregulation and an infectious context and the notion of tuberculosis contagion, the diagnosis is confirmed by the anatomo-pathological study. Pituitary MRI shows a process occupying the sellar compartment with heterogeneous hypersignal in T2 and isosignal in T1, enhanced in T1, enhanced in the periphery. Filling of the optochiasmatic cistern. The physiological hypersignal of the post-physiological pituitary cannot be individualized. The most common medications used to treat tuberculosis if early diagnosis without visual repercussions if not associated surgery via the transsphenoidal approach.

Pituitary tuberculosis: a cause of giant cell granulomatous hypophysitis presented with hypopituitarism

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Pituitary tuberculosis

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Pituitary tuberculosis

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

P50 Pituitary Granulomata - TB or Not TB

Granulomatous disease of the pituitary gland is rare and of this pituitary tuberculosis (TB) is the rarest, making its diagnosis or exclusion challenging. We discuss six cases. Patients ages ranged...

Pituitary hCG production and cerebral tuberculosis mimicking disease progression during chemotherapy for an advanced ovarian germ cell tumour

BackgroundOvarian germ cell tumours (OGCT) are rare but are usually curable with chemotherapy, even when presenting with advanced disease. The majority of OGCT produce the tumour markers, hCG and/or AFP which can be helpful in the diagnosis and monitoring the response to treatment.Case PresentationIn this case of a 36 year old woman, the elevated hCG level at presentation was helpful in making a clinical diagnosis of OGCT in a patient too unwell to permit a tissue diagnosis.Cisplatin based combination chemotherapy produced an initial normalisation of the hCG level, but later in treatment the patient developed new cerebral lesions and a rising serum hCG suggestive of disease progression.Further investigations suggested that the CNS lesions were cerebral TB and that the low levels of hCG elevations was likely to be pituitary in origin. Chemotherapy treatment was continued along with anti-tuberculous therapy and 24 months after successful completion of therapy the patient remains disease free.ConclusionsIn the treatment of cancer patients it may be helpful to consider the potential non-malignant causes of new CNS lesions and that low hCG elevations may result from physiology rather than pathology in selected cases.

La tuberculose hypophysaire : à propos d’un cas

Through a case of sellar and suprasellar tuberculoma which presented with central diabetes insipidus, the authors report the frequency of pituitary tuberculoma, its physiopathology, clinical presentation hormonal and radiological findings thus management and evolution. A 42 years old woman, with a history of erythema nodosum, presented with polyuria polydipsia (PUPD), amenorrhea and galactorrhea. Endocrine investigations showed central diabetes insipidus, elevated serum prolactin levels and cortisol failure. Magnetic resonance imagining scans (MRI) revealed a nodular thickening of the pituitary enlargement and loss of posterior pituitary hypointensity signal. Etiologic inquiry has removed the diagnosis of sarcoidosis, Langerhan's histosis, autoimmune hypophysitis and sellar metastasis. The history of erythema nodosum, the positivity of tuberculin skin test and the presence of koch bacillus in the bronchial fluid after culture led to a diagnosis of tuberculosis. Treatment was started with four drug antitubercular chemotherapy regimen for 2 months, and tow drug antitubercular chemotherapy regimen for 16 months. This treatment is associated with hydrocortisone, desmopressin nasal spray and bromocriptine. Under treatment, there was an improvement in clinical condition, disapearence of headache, PUPD and galactorrhea thus normalization of prolactin. A follow-up MRI, 8 months later, showed that pituitary lesion has been completely removed, suggesting our clinical and biology presumption. Pituitary tuberculosis is rare, however, when encountered, they may present a diagnostic difficulty. Accurate diagnosis and management is important because pituitary tuberculoma is curable.

Imagerie des tuberculomes intra-sellaires : rapport de 2 cas

Hypophyseal tuberculoma is extremely rare. It may be confused with other more common sellar tumors such as adenomas. Characteristic, but not specific, radiological features are in the majority of cases: intense enhancement on contrast CT and thickening of the pituitary stalk better visible on MRI. We describe imaging findings in two patients with pituitary tuberculosis. In these cases an accurate non-invasive diagnosis was found to be important as antituberculous chemotherapy is curative.

An Unusual Association of Acromegaly and Pituitary Tuberculosis

A young woman with acromegaly and disseminated tuberculosis involving pituitary is reported. She presented with classical features of acromegaly and was found to have retrocrural and retroperitoneal lymphadenopathy. Such association is quite rare.

Intrasellar tuberculoma — an enigmatic pituitary infection: a series of 18 cases

Objective: Intrasellar tuberculomas are rare and only few case reports have been described in the literature. We report a series of 18 cases of histologically proven intrasellar tuberculomas, which, to the best of our knowledge, is the largest series in the English literature. Methods: A total of 1143 pituitary lesions, between 1984 and June 1999, were operated for various reasons in our institute. Of these, 18 cases were histopathologically proven intrasellar tuberculomas. The clinical profile was reviewed in detail. Radiological data and histopathological slides were also reviewed. Results: The age ranged from 8 to 43 years (average 23.6 years) with a female preponderance. The duration of symptoms varied from 15 days to 2 years (average 4 months), the most common symptoms being headache followed by decrease or loss of vision. Five patients had features of pan-hypopituitarism whereas three had raised prolactin (PRL) levels. In six patients, both sella as well as sphenoid sinus were involved. In one patient the lesion was extending from the sella over the clivus. Clinically as well as radiologically, these lesions were mistaken for pituitary adenomas except for one case where tuberculoma was suspected on imaging. In three patients, there was past history of pulmonary tuberculosis, in one patient of tuberculous meningitis, and in one patient, of spondilytis of the spine. In one patient there was cervical lymphadenopathy along with features of acromegaly (also proved by high levels of serum growth hormone) and radiology revealed a pituitary pathology. Microscopic examination of the excised lesion revealed a composite lesion consisting of a pituitary adenoma and tuberculoma, which has not been documented in literature to date. One patient died during the hospital stay. All the other patients were put on antitubercular chemotherapy following surgery and had good outcomes. Conclusion: Intrasellar tuberculomas are rare. These may be suspected in female patients especially if radiological imaging shows involvement of paranasal sinuses and pituitary fossa along with thickening of pituitary stalk. Simultaneous involvement of clivus may also be an additional feature. The incidence of pituitary tuberculosis is likely to increase with a rise in the incidence of AIDS.

Imaging in pituitary tuberculosis

Tuberculosis of the pituitary gland is extremely uncommon and may masquerade as a nonfunctional pituitary neoplasm. We describe imaging findings in three patients with pituitary tuberculosis and review the pattern of involvement and importance of imaging in its management. An accurate diagnosis was found to be important in these cases as antituberculous chemotherapy was curative.

Infectious disease in the sella turcica.

Intrasellar infection is characterized by pituitary dysfunction and damage to surrounding structures. In most cases patients have fever, headache, and visual disturbance and exhibit roentgenographic evidence of a mass. Suppurative infections may originate in the paranasal sinuses, meninges, or more distant foci and are commonest in the setting of preexisting pituitary adenomata. Pituitary tuberculosis may arise from hematogenous spread or extension of local lesions and may be confused with a variety of other granulomatous diseases. Congenital and acquired syphilis of the pituitary are more often diagnosed at autopsy or by the concurrence of pituitary dysfunction and serologic evidence of syphilis. Although viral infection may be associated with pituitary or hypothalamic dysfunction, overt hypophyseal infection is rarely documented. In contrast, a variety of parasites and fungi have been found in pituitary tissue. The diagnosis of pituitary infection should be considered when signs of intrasellar mass or pituitary dysfunction are accompanied by fever and other evidence of infection.