Primary Pituitary Tuberculosis Revisited.

Autor: Ben Abid F; Division of Infectious Disease, Department of Medicine, Hamad General Hospital, Doha, Qatar., Abukhattab M; Division of Infectious Disease, Department of Medicine, Hamad General Hospital, Doha, Qatar., Karim H; Division of Infectious Disease, Department of Medicine, Hamad General Hospital, Doha, Qatar., Agab M; Division of Infectious Disease, Department of Medicine, Hamad General Hospital, Doha, Qatar., Al-Bozom I; Department of Pathology, Hamad General Hospital, Doha, Qatar., Ibrahim WH; Department of Medicine, Hamad General Hospital, Doha, Qatar.
Jazyk: angličtina
Zdroj: The American journal of case reports [Am J Case Rep] 2017 Apr 12; Vol. 18, pp. 391-394. Date of Electronic Publication: 2017 Apr 12.
DOI: 10.12659/ajcr.903233
Abstrakt: BACKGROUND Primary pituitary tuberculosis (in absence of other organ involvement and constitutional symptoms) is an extremely rare disease with total reported cases in the literature fewer than a hundred. Misdiagnosis as pituitary adenoma is common and late diagnosis can result in a permanent endocrine dysfunction and/or long-term neurologic sequelae. CASE REPORT We report on the case of a middle-aged woman who presented with severe headache and left third cranial nerve palsy. Magnetic resonance imaging (MRI) revealed a large pituitary tumor invading the left cavernous sinus. The case was initially misdiagnosed as pituitary adenoma. A pituitary biopsy was performed and was suggestive of pituitary tuberculosis. Extensive radiologic investigations did not reveal any evidence of other organ involvement by tuberculosis. She was successfully treated with anti-tuberculous medications. CONCLUSIONS In areas with a high pre-test probability of tuberculosis, pituitary tuberculosis should be included in the differential diagnosis of pituitary tumors in order to avoid unnecessary surgical interventions. Besides being the first histologically-proven primary pituitary tuberculosis case reported from Qatar, the current case is unique in that extensive radiologic investigations did not reveal any evidence of other systemic or pulmonary tuberculosis.
Databáze: MEDLINE
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