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Extensive Inflammatory Pseudotumor of the Pituitary

Departments of Neurology (I.H., F.C.), Endocrinology (P.P., A.B.), Pathology (A.T.), Neuroradiology (P.F.), and Neurosurgery (A.S.), University of Liege, 4000 Liege, Belgium; Department of Endocrinology, University of Lausanne (R.C.G.), 1011 Lausanne, Switzerland; Department of Pathology, St. Michael’s Hospital (K.K.), M5B 1W8 Toronto, Canada; and Department of Pathology, University of Geneva (P.P.), 1211 Geneva, Switzerland

Address all correspondence and requests for reprints to: Prof. A. Beckers, Service d’Endocrinologie, CHU Liege, Domaine Universitaire du Sart Tilman, B 4000, Liege, Belgium. E-mail: albert.beckers{at}chu.ulg.ac.be

Abstract

A 40-yr-old female presented with an extensive lesion of the sellar area and the sphenoid sinus, spreading to the optic nerves and associated with pachymeningitis. Histological findings were consistent with an inflammatory pseudotumor, and steroid treatment allowed the disappearance of all the lesions.

Inflammatory pseudotumors of the pituitary are very rare. This case appears unique with regard to the extension of the lesions and the dramatic response to medical treatment. The differential diagnosis of inflammatory lesions of the pituitary is difficult. It relies mainly on histological analysis and includes sarcoidosis, Wegener’s granulomatosis, histiocytosis (Langerhans, Rosai-Dorfman, and Erdheim-Chester diseases) and lymphocytic hypophysitis.

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