Article

Lymphocytic adenohypophysitis mimicking a pituitary macroadenoma.

Klinik für Neurochirurgie der Universität zu Köln, Germany.
Neurosurgical Review (impact factor: 2.04). 07/2000; 23(2):112-6. pp.112-6
Source: PubMed

ABSTRACT A 24-year-old woman developed headache and rapidly progressive visual disturbances during the last trimester of her first pregnancy. Magnetic resonance tomography (MRI) of the brain documented an intra- and suprasellar mass lesion. For preservation of vision, transsphenoidal microsurgical decompression was performed. Immediately postoperatively, visual acuity improved and hemianopia resolved. Histological examination yielded the diagnosis of primary lymphocytic adenohypophysitis. This is a rare inflammatory pituitary disease. There are no typical clinical, laboratory, or radiological findings that allow precise preoperative diagnosis. Even though this autoimmune disorder is principally steroid-responsive, an improvement of visual disturbances under steroid therapy cannot be predicted. Therefore, surgery is justified not only to establish the diagnosis, but also to restore vision by decompression of the optic nerves and the chiasm.

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Keywords

24-year-old woman
 
allow precise preoperative diagnosis
 
chiasm
 
first pregnancy
 
Histological examination
 
intra-
 
optic nerves
 
progressive visual disturbances
 
radiological findings
 
rare inflammatory pituitary disease
 
transsphenoidal microsurgical decompression
 
typical clinical
 
visual acuity
 
visual disturbances
 

C Alexiadou-Rudolf