[Tuberculomas intrasellaires: about 2 cases]

ABSTRACT

Sellar tuberculomas are extremely rare. Their diagnosis is difficult because other intrasellar lesions may have the same clinical and radiological appearance. We report two cases, in which the diagnosis was made on the basis of clinical, paraclinical and therapeutic arguments. The first observation is a 42-year-old unmarried woman who presented with central diabetes insipidus and secondary amenorrhoea. Magnetic resonance imaging [MRI] revealed a nodular thickening of the pituitary stalk, an increased size of the pituitary gland and a loss of the posterior pituitary hyperintensity signal at T1. The tubercular origin of these lesions was deducted from the presence of tubercle Bacillus in the bronchial fluid, and the favourable evolution after anti tubercular treatment. The second observation is a 29-year-old woman with secondary amenorrhoea at the 12th month of treatment for tubercular pleuropulmonary lesions and meningitis confirmed by the presence of Tubercle Bacillus in the cerebrospinal fluid. The MRI revealed a multinodular expansive processus that encircled the pituitary stalk and extended to the infuncibular and hypothalamic regions. These nodules regressed with continuation of the same antitubercular treatment