Quick Case: Sellar tuberculoma presenting as pituitary adenoma

A 43–year-old woman presented with polyuria polydipsia (PUPD), amenorrhea and galactorrhea for the last 2 years. Investigations revealed central diabetes insipidus, elevated serum prolactin levels and cortisol failure. MRI showed a nodular thickening of the enlarged pituitary with loss of the posterior pituitary hypointensity signal, suggesting pituitary adenoma. Post-surgery histopathology revealed classical epithelioid cell granuloma with necrosis and Langhans giant cells.

Tubercular involvement of the pituitary is extremely rare and generally not suspected, even in patients with a history of systemic tuberculosis. Diagnosis of sellar tuberculoma is difficult on clinical and radiological examinations, which should be considered in the differential diagnosis of suprasellar masses, especially in developing countries, as the condition is medically curable.

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