2021•Journal of Clinical Ophthalmology and ResearchOpen access

A rare case report of hypophysitis in pituitary macroadenoma mimicking pituitary apoplexy

Akkayasamy Kowsalya, Sivagami Nachiappan, Mahesh M. Kumar

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Abstract

Hypophysitis, a rare inflammatory disorder of the pituitary gland is often misdiagnosed as mass lesion. Granulomatous hypophysitis presenting clinically as pituitary apoplexy is rare. A 23-year-old woman with pituitary macroadenoma presented with sudden diminution of vision in the right eye with features clinically mimicking pituitary apoplexy. Imaging revealed pituitary macroadenoma with hypophysitis. After a course of high-dose intravenous corticosteroids, her visual acuity improved to 6/6. Although apoplexy and hypophysitis have subtle clinical and radiological differences, it is essential to differentiate them to avoid unnecessary invasive procedures when conservative treatment can suffice.

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Hypophysitis, a rare inflammatory disorder of the pituitary gland is often misdiagnosed as mass lesion. Granulomatous hypophysitis presenting clinically as pituitary apoplexy is rare. A 23-year-old woman with pituitary macroadenoma presented with sudden diminution of vision in the right eye with features clinically mimicking pituitary apoplexy. Imaging revealed pituitary macroadenoma with hypophysitis. After a course of high-dose intravenous corticosteroids, her visual acuity improved to 6/6. Although apoplexy and hypophysitis have subtle clinical and radiological differences, it is essential to differentiate them to avoid unnecessary invasive procedures when conservative treatment can suffice.

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Available abstract

Hypophysitis, a rare inflammatory disorder of the pituitary gland is often misdiagnosed as mass lesion. Granulomatous hypophysitis presenting clinically as pituitary apoplexy is rare. A 23-year-old woman with pituitary macroadenoma presented with sudden diminution of vision in the right eye with features clinically mimicking pituitary apoplexy. Imaging revealed pituitary macroadenoma with hypophysitis. After a course of high-dose intravenous corticosteroids, her visual acuity improved to 6/6. Although apoplexy and hypophysitis have subtle clinical and radiological differences, it is essential to differentiate them to avoid unnecessary invasive procedures when conservative treatment can suffice.

Key concepts: Hypophysitis, Medicine, Pituitary apoplexy, Pituitary gland, Pituitary adenoma, Radiology, Presentation (obstetrics), Surgery

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