Primary pituitary tuberculoma with a pituitary apoplexy-like presentation

Primary pituitary tuberculoma with a pituitary apoplexy-like presentation

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Pituitary tuberculoma is extremely rare and may pose as a diagnostic challenge especially when encountered as an isolated lesion without other systemic manifestation of tuberculosis.A 21-year-old female was admitted for diabetic ketoacidosis.On the third day of admission following the resolution of diabetic ketoacidosis she developed a sudden onset of headache and Custom Hoodie blurring of vision suggestive of pituitary apoplexy.An urgent MRI brain revealed a large sellar mass with erosion into the sphenoid sinus and intracranial vasculitis.

Transphenoidal surgery was done for tumour debulking which allowed histopathological examination of the sellar mass.Immunohistochemical examination of the sellar mass was positive for Gene Xpert MTB/Rif suggesting a Car Model Kit tuberculoma.Anti-tuberculous therapy was commenced with full recovery of pituitary hormonal profile seen 7 months post-treatment.In regions with a high incidence of tuberculosis, a tuberculoma should be a considered in a diagnostic evaluation of a sellar lesion.