Atypical Sellar Mass: Sellar Tuberculoma in a Young Patient - Case Report

Abstract

BACKGROUND: Central nervous system involvement, though uncommon, is one of the most severe form of tuberculosis. Its manifestations include tuberculoma and tuberculous meningitis, with the majority of cases affecting children and immunocompromised patients. Overall, tuberculomas account for 0.15–2 % of all intracranial lesions but sellar tuberculoma is extremely rare. THE CASE:18 yr. old female patient presented with complain of generalized weakness ,eye pain, headache since 3-4 months .Brain Magnetic resonance imaging (MRI)showed sellar and suprasellar space occupying lesion. Trans sphenoidal approach was used to remove the lesion completely .The pathological evaluation confirmed a tuberculoma and the patient was put on postoperative anti-tubercular therapy. CONCLUSION: Although rare, intracranial tuberculomas, particularly those that originate in the sellar, are notorious for mimicking pituitary tumours by jeopardizing pituitary hormonal function and applying compressive forces on surrounding intracranial structures. However, a prompt assessment can help overcome this diagnostic difficulty with the timely initiation of anti-tubercular therapy (ATT).