Giant-cell granulomatous hypophysitis

OBJECTIVE: To describe the clinical features of giant-cell granulomatous hypophysitis and to report on the results of corticosteroid treatment.

METHODS: A case of giant-cell granulomatous hypophysitis is presented, and the pertinent literature is reviewed.

RESULTS: A 41-year-old woman with anterior pituitary dysfunction had a pituitary mass that was 18 by 16 by 13 mm by magnetic resonance imaging. The pituitary stalk was thickened and enhanced after intravenous administration of gadolinium. A biopsy specimen that was obtained at transsphenoidal pituitary exploration revealed that the patient had giant-cell granulomatous hypophysitis, a rare inflammatory pituitary disorder. High-dose corticosteroid therapy failed to reverse her anterior pituitary dysfunction.

CONCLUSION: The coincidence of a contrast-enhancing pituitary mass with a thickened pituitary stalk and the awareness of the rare occurrence of endocrine inactive tumors in women of childbearing age should suggest an inflammatory pituitary condition. Such lesions should also be suspected in otherwise healthy young women with hypopituitarism and no evidence of hormone hypersecretion. On the basis of the literature and our experience, corticosteroid treatment does not seem to improve anterior pituitary function.