Development of an Empty Sella in Neurosarcoidosis

Arshpreet Kaur
2017 Open access Journal of Neurology & Neurosurgery  
We report the case of a 56 year old African American woman who presented with headache, difficulty walking and loss of hearing and vision who had undiagnosed diabetes insipidus and pan-hypopituitarism. MRI revealed inflammation of the meninges with thickening of the pituitaryinfundibulum and hypothalamus with spread to the optic chiasm and optic nerves. Dura biopsy confirmed the clinical diagnosis of isolated neurosarcoidosis. During 8 months of treatment with prednisone and methotrexate, there
more » ... methotrexate, there was partial resolution of the dura thickening but the neurological manifestations and the endocrine disorder were unaffected. Swelling of the pituitary became an empty sella. Learning Points: A. The diagnosis and treatment of isolated neurosarcoidosis can be challenging. B. Neurosarcoidosis can present with hypopituitarism, diabetes insipidus and hyperprolactinemia. C. This case report demonstrates the evolution of a pituitary mass in a patient with neurosarcoidosis into an empty sella.
doi:10.19080/oajnn.2017.03.555605 fatcat:tuxxr5czlffjbgjqztk4wf3o64