May 2005
Volume 46, Issue 13
ARVO Annual Meeting Abstract  |   May 2005
Giant Cell Granulomatous Hypophysitis Mimicking a Giant Pituitary Macroadenoma
Author Affiliations & Notes
  • A. Chan
    Ophthalmology, Singapore National Eye Center, Singapore, Singapore
  • I. Sng
    Pathology, Singapore General Hospital, Singapore, Singapore
  • J.F. Cullen
    Ophthalmology, Singapore National Eye Center, Singapore, Singapore
  • Footnotes
    Commercial Relationships  A. Chan, None; I. Sng, None; J.F. Cullen, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 620. doi:
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      A. Chan, I. Sng, J.F. Cullen; Giant Cell Granulomatous Hypophysitis Mimicking a Giant Pituitary Macroadenoma . Invest. Ophthalmol. Vis. Sci. 2005;46(13):620.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: To present a case of giant cell granulomatous hypophysitis mimicking a giant pituitary macroadenoma and literature review. Methods: A case report Results: A 52–year–old Chinese female with no previous endocrine or autoimmune disease, presented with a history of blurring of vision in the left eye associated with headache. A bitemporal visual field defect was found. She underwent a MRI and was diagnosied as having a pituitary adenoma with suprasellar extension compressing the optic chiasma. She was also found to have panhypopituitarism. Interestingly, when she was listed for an endoscopic trans–sphenoidal excision of the tumour, intra–operative findings showed a yellow, firm lesion inconsistent with an adenoma and only a biopsy was performed. Histology revealed a diagnosis of giant cell granulomatous hypophysitis. Conclusions: Granulomatous inflammation of the pituitary gland is a rare disease. There is associated panhypopituitarism, and rarely hyperprolactinemia. It can present clinically to an ophthalmologist with a bitemporal visual field defect and thus mimic a pituitary macroadenoma. As it is hard to differentiate this difference based on radiology, most diagnoses are based on histology. Our patient's symptoms of headache and her visual field defect were relieved after the biopsy. However, her endocrine problem of panhypopituitarism remained.

Keywords: neuro-ophthalmology: diagnosis • inflammation • neuro-ophthalmology: cortical function/rehabilitation 

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