Prabha Blessy Balaji, Rangachari Vijay, Subramaniam Venugopal, Gopan Thottatil Viswanathan, Baliga Vidya Bhat
Department of Otorhinolaryngology, Manipal Hospitals Whitefield, Bengaluru, Karnataka, India.
Department of Neurosurgery, Manipal Hospitals Whitefield, Bengaluru, Karnataka, India.
Asian J Neurosurg. 2021 Mar 20;16(1):141-143. doi: 10.4103/ajns.AJNS_371_20. eCollection 2021 Jan-Mar.
We present a rare case of a pituitary tuberculoma masquerading as pituitary adenoma with pituitary apoplexy-like presentation in a 31-year-old female, who had symptoms suggestive of acute secondary adrenal insufficiency with secondary amenorrhea. After initial evaluation which was suggestive of pituitary adenoma, she underwent endoscopic transnasal pituitary tumor excision. Histopathology revealed features of pituitary tuberculoma. She was subsequently started on four drug anti-tubercular therapy and is on follow-up. Although uncommon, tuberculomas, especially in the pituitary gland, are known for behaving like pituitary adenomas, by impairment of pituitary hormonal function and by exerting pressure effects on surrounding vital intracranial structures. Diagnostic challenges, treatment modality, and literature review are presented in this case report. Pituitary tuberculoma even though a rare entity should be borne in mind as a differential diagnosis in a patient manifesting with pituitary apoplexy-like syndrome.
我们报告了一例罕见病例，一名31岁女性，垂体结核瘤伪装成垂体腺瘤，表现为垂体卒中样症状，伴有提示急性继发性肾上腺功能不全和继发性闭经的症状。在初步评估提示垂体腺瘤后，她接受了内镜经鼻垂体肿瘤切除术。组织病理学显示为垂体结核瘤的特征。随后她开始接受四联抗结核治疗并进行随访。尽管不常见，但结核瘤，尤其是垂体结核瘤，因其损害垂体激素功能并对周围重要颅内结构施加压力效应，而表现得像垂体腺瘤。本病例报告介绍了诊断挑战、治疗方式及文献综述。垂体结核瘤虽是罕见疾病，但在表现为垂体卒中样综合征的患者中应作为鉴别诊断予以考虑。
