Pituitary tuberculoma is extremely rare and may pose as a diagnostic challenge especially when encountered as an isolated lesion without other systemic manifestation of tuberculosis.A 21-year-old female was admitted for diabetic ketoacidosis.On the third day of Hair Care Kits admission following the resolution of diabetic ketoacidosis she developed a sudden onset of headache and blurring of vision suggestive of pituitary apoplexy.
An urgent MRI brain revealed a large sellar mass with erosion into the sphenoid sinus and intracranial vasculitis.Transphenoidal surgery was done for tumour debulking which allowed histopathological examination of the sellar mass.Immunohistochemical examination of the sellar mass was positive for Gene Range Extender Xpert MTB/Rif suggesting a tuberculoma.
Anti-tuberculous therapy was commenced with full recovery of pituitary hormonal profile seen 7 months post-treatment.In regions with a high incidence of tuberculosis, a tuberculoma should be a considered in a diagnostic evaluation of a sellar lesion.