Endocrine Abstracts

Introduction: Tuberculosis is a serious disease which is on the increase worldwide, particularly in poor and developing countries, killing 3.000.000 people every year. Preferential localization is lungs, kidneys and the bones. Rare at the brain, it’s exceptional at the pituitary gland. Diagnosis is usually very difficult, even simulate a pituitary adenoma, thus imposing a surgical treatment, and it is the pathologist who will rectify the diagnosis.

Observation: This is a 23-year-old patient admitted with anterior pituitary insufficiency with palpebral ptosis and polyuropolydypsia syndrome. Patient had a history of tuberculous meningoencephalitis for 05 months still under treatment. Endocrine assessment revealed global anterior pituitary insufficiency with hyperprolactinemia, associated with post pituitary insufficiency. Hypothalamohypophyseal magnetic resonance imaging revealed a suprasellar collection centred on the pituitary stalk measuring 10×11×18 mm in diameter with a liquid signal. Patient was put on hormone replacement therapy, which is currently being monitored.

Discussion: Pituitary tuberculosis remains an exceptional pathology, frequency is difficult to determine because only a few rare sporadic cases have been published in the literature. Clinical symptomatology mimics that of a non-secreting pituitary adenoma. Damage to the cavernous sinus is very frequently observed. Diagnosis is difficult when a late complication of a primary tuberculosis infection that goes unnoticed, less after tuberculosis meningitis.

Conclusion: Common challenge for clinician and radiologist is to determine which patients are likely to have a tuberculoma, diagnosis must be rapid, given the possibility of cure through early and well-conducted medical treatment.