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12 April 2017 : Case report  Qatar

Primary Pituitary Tuberculosis Revisited

Mistake in diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Fatma Ben Abid1ABCDEFG, Mohammed Abukhattab1ABCDEFG, Hanfa Karim1ABDF, Mohamed Agab1ABDFG, Issam Al-Bozom2ABFG, Wanis H. Ibrahim3ABDEFG*

DOI: 10.12659/AJCR.903233

Am J Case Rep 2017; 18:391-394

Abstract

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.

Keywords: Pituitary Neoplasms, Tuberculosis, Central Nervous System, Tuberculosis, Endocrine

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923