Sellar Tuberculoma: An unusual infection.
Loading...
Date
2005-10
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Tuberculomas are common intracranial lesions in our country. However, tubercular infection of pituitary
gland is very unusual. We present a case of intrasellar tuberculoma mimicking pituitary adenoma, and suggest the
radiological features and management. A 22-year-old woman had presented with generalized dull aching mild to moderate
headache for 8 months and decreased vision in both eyes for 6 months. Visual acuity was 6/9 in both eyes but visual fields
and fundus examination were normal. There were no other significant findings. CT scan and MRI (brain) showed a
sellar- suprasellar lesion. The pituitary stalk was thickened, as was the mucosa of sphenoid sinus, which raised the
suspicion of an infectious pathology other than pituitary macroadenoma. Surgery was performed through sublabial
transsphenoid route. A firm, rubbery, yellowish, non-suckable and relatively avascular lesion was found in the sella. Only
subtotal decompression was done. Frozen section biopsy was suggestive of inflammatory pathology. Histopathology
revealed features compatible with tuberculosis. We suggest that tuberculosis should be considered in the differential
diagnosis of sellar lesions, especially if associated with contrast enhancement and thickening of sphenoid sinus mucosa
or pituitary stalk, particularly in patients from tuberculosis endemic areas. Most of these patients are negative for
workup for systemic tuberculosis. Intraoperatively, a frozen section should be sent and if it shows inflammatory
pathology, only a decompression for biopsy should be done. We do not advise radical decompression of these lesions as
anti-tubercular treatment is sufficient for cure.
Description
Keywords
Tuberculosis, Pituitary gland, sella
Citation
Ahmad Faiz Uddin, Chandra P Sarat, Sanyal Sujoy, Garg Ajay, Mehta Veer Singh. Sellar Tuberculoma: An unusual infection. Indian Journal of Tuberculosis. 2005 Oct; 52(4): 215-217.