NEUROSARCOIDOSIS PRESENTING AS HYPOPITUITARISM AND A CYSTIC PITUITARYMASS

We report a young woman with clinical hypopituitarism and systemic sar coidosis involving the lung, gastrointestinal tract, and peripheral ly mph nodes, Laboratory evaluation confirmed that cortisol, thyroid indi ces, insulin-like growth factor 1, follicle-stimulating hormone, lutei nizing hormone, and estradiol levels were low, with a normal prolactin , Magnetic resonance imaging revealed a large cystic pituitary lesion compressing the optic chiasm and exhibiting rim but not hypothalamic e nhancement, The differential diagnosis included cystic macroadenoma, R athke's cleft cyst, craniopharyngioma, and simple cyst, A transsphenoi dal procedure provided decompression and diagnosis: pathology was cons istent with sarcoidosis, Postoperatively, the patient's neurosarcoid d isease markedly worsened, requiring hypothalamic irradiation, To our k nowledge, this is the first report of intracranial sarcoidosis present ing solely as a cystic pituitary mass. An awareness of this possibilit y is important to prevent inappropriate neurosurgical intervention and subsequent potential exacerbation of neurosarcoidosis.