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Journal of Oncology
Volume 2010, Article ID 195323, 5 pages
http://dx.doi.org/10.1155/2010/195323
Case Report

Xanthomatous Hypophysitis Mimicking a Pituitary Adenoma: Case Report and Review of the Literature

1Department of Neurosurgery, Brotzu Hospital, Via Peretti 1, 09100 Cagliari, Italy
2Department of Pathological Anatomy, Brotzu Hospital, 09100 Cagliari, Italy

Received 28 January 2010; Revised 20 May 2010; Accepted 4 June 2010

Academic Editor: Ian E. McCutcheon

Copyright © 2010 Laura Aste et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Hypophysitis is an inflammatory disease of the pituitary gland that may mimic pituitary tumors clinically and radiologically. Case Description. We report a case of a xanthomatous hypophysitis initially diagnosed as pituitary adenoma. A 31-year-old woman presented with headache, diabetes insipidus, and amenorrhea. A head CT scan showed no intrasellar changes, while an MRI scan showed a sellar cystic mass. An endocrinological work up revealed mild hypocortisolism and diabetes insipidus (DI). Transsphenoidal surgery was performed. The intraoperative histological examination suggested a pituitary adenoma. The removed tissue showed central necrosis surrounded by accumulation of foamy cells and xanthomatous epithelioid cells. The patient made an uneventful postoperative recovery, Nevertheless, DI persisted and the adenohypophysis hypofunction did not recover. Conclusion. We describe an unusual inflammatory lesion of the pituitary gland mimicking an adenoma. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.