Sellar space-occupying lesion: not always a pituitary tumour!

Background and objective: Hypophysitis is an inflammatory disease of the pituitary gland that is clinically and radiologically similar to pituitary tumours. We are reporting a case of xanthogranulomatous hypophysitis which was confused as a pituitary neoplasm preoperatively. Materials and methods: A 56-year-old woman presented with extreme tiredness and visual disturbances for 4 months and had visited multiple doctors for the same. NCCT head and CEMRI done preoperatively were suggestive of sellar SOL. The patient was optimised preoperatively and underwent trans-nasal transsphenoidal surgery was performed. Histologic examination of the tissue was s/o xanthogranulomatous hypophisitis Conclusion: We have described an unusual inflammatory lesion of the pituitary in the sellar region that was mimicking neoplasm. A high level of clinical suspicion and knowledge regarding the differential diagnosis of the sellar region is necessary for correct diagnosis and management. Key message: All the sellar space occupying lesions are not always pituitary adenomas. Rare entities like xa thogranulomatous hypophisitis should be thought of when we encounter patients with hypocortisolism.