Pituitary T-lymphoblastic lymphoma combined with pituitary adenoma: a rare case report

Background T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive malignancy that originates from immature precursor T lymphocytes and is characterized by rapid progression. The typical clinical manifestations of T-LBL include superior vena cava syndrome and respiratory compression symptoms such as cough and dyspnea caused by large anterior mediastinal masses. Primary pituitary T-LBL is exceptionally rare, with only seven cases reported worldwide (including the case described in this study). Case presentation This article presents the case of an elderly female patient who presented with headaches and progressive visual deterioration. Brain MRI revealed a sellar/suprasellar mass, while whole-body PET/CT imaging revealed a tumor confined to the central nervous system. Laboratory tests for blood parameters and pituitary hormone levels were normal. Following neuroendoscopic tumor resection, pathological examination and immunohistochemical analysis confirmed a diagnosis of pituitary T-LBL coexisting with pituitary adenoma. The patient’s headaches and visual impairment were resolved postoperatively. Subsequent chemotherapy with high-dose methotrexate (HD-MTX), temozolomide, and liposomal doxorubicin effectively controlled the disease. Conclusions This case highlights the rarity of concurrent sellar lymphoma and pituitary adenoma and summarizes previously reported cases of primary pituitary T-LBL to provide clinical diagnostic and therapeutic insights into this rare disease.