Pituitary inflammatory pseudotumor with amenorrhea, polyuria, and impaired vision: case report and review of the literature

Inflammatory pseudotumor (IPT) is a soft tissue lesion of unknown etiology. In 2002 the WHO classified it as a soft tissue tumor, and renamed it inflammatory myofibroblastic tumor. Inflammatory pseudotumor may involve various organs and tissues of the body, mainly the lungs and eyes. Primary intracerebral inflammatory pseudotumor is rare. If the differential diagnosis of IPT is made, surgical treatment can be avoided and the patient's trauma and risk can be reduced. We present a case of a 25-year-old female who presented with amenorrhea, galactorrhea, polydipsia, and polyuria. Magnetic resonance image (MRI) demonstrated a tumor (15 mm in diameter) with suprasellar extension, optic nerve compression, and pituitary stalk involvement. Preoperative examination showed a large increase in prolactin and laboratory data showed elevation of the erythrocyte sedimentation rate, but other data were within normal ranges. We applied a lateral transfrontal approach by microscopic resection of the endplate saddle area, because it was large. Postoperative pathology confirmed IPT. Small doses of hormone and thyroxine were given after surgery, and most of the tumor was resected after re-examination. Two years after the operation, no recurrence or other abnormalities were found. Attention should be paid to the differential diagnosis of inflammatory pseudotumor of pituitary. Steroid hormone therapy can be used first to observe its effect. It can reduce the harm caused by invasive operation.