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 CASE REPORT
Year : 2021  |  Volume : 69  |  Issue : 5  |  Page : 1414--1420

A Rare Case of Primary Pituitary Tubercular Abscess Mimicking a Pituitary Adenoma


1 Department of Neurosurgery, Dr. D.Y. Patil Medical College and Hospital, Pune, Maharashtra, India
2 Department of Ophthalmology and Neurosurgery, Dr. D.Y. Patil Medical College and Hospital, Pune, Maharashtra, India

Correspondence Address:
Sarang Gotecha
Department of Neurosurgery, Dr. D.Y. Patil Medical College, Hospital and Research Center, Sant Tukaram Nagar, Pimpri, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.329622

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Primary pituitary tuberculosis (PTA) is a very rare disease. The clinical diagnosis is difficult as it is clinically radiologically indistinguishable from other sellar lesions. We present a case of PTA without any predisposing etiology and radiologically mimicking a pituitary macroadenoma. The patient underwent endoscopic transsphenoidal resection where pus admixed with mucoid was seen coming out of the lesion intraoperatively. Histology of the cyst wall was suspective of tuberculous etiology and QuantiFERON Tb Gold done for confirmation was positive. Postoperatively patient showed obvious improvement in visual symptoms. Patient developed diabetes insipidus and was put on desmopressin and was started with anti-tuberculosis medication for 18 months. Timely surgical intervention followed by anti-tubercular therapy and hormone replacement is the mainstay of treatment in these cases. For intraoperative management, we advise thorough wash with antibiotic and saline rather than curetting the walls of the abscess to decrease the postoperative incidence of endocrine abnormalities.






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