Extensive inflammatory pseudotumor of the pituitary

A 40-yr-old female presented with an extensive lesion of the sellar area an d the sphenoid sinus, spreading to the optic nerves and associated with pac hymeningitis. Histological findings were consistent with an inflammatory ps eudotumor, and steroid treatment allowed the disappearance of all the lesio ns. Inflammatory pseudotumors of the pituitary are very rare. This case appears unique with regard to the extension of the lesions and the dramatic respon se to medical treatment. The differential diagnosis of inflammatory lesions of the pituitary is difficult. It relies mainly on histological analysis a nd includes sarcoidosis, Wegener's granulomatosis, histiocytosis (Langerhan s, Rosai-Dorfman, and Erdheim-Chester diseases) and lymphocytic hypophysiti s.