Table of Contents
Washington University Experience | MISCELLANEOUS | Hypophysitis | Hypophysitis - Granulomatous | 4A0 Case 4 History
Case 4 History ---- The patient is a 59yo female with a past medical history of T2DM (HbA1c 6.3%), hypertension, hyperlipidemia, hyperthyroidism, and left clinoid meningioma s/p frontotemporal craniotomy for tumor resection in March 2024. The resected meningioma was CNS WHO Grade 1 and Ki67 of 2.4%; however, a comment was made that there was a prominent lymphocytic inflammatory infiltrate (no granulomatous features were described). In October 2024 she presented with an approximately 1 month history of worsening diplopia. An MRI follow up then showed a 3 cm mass extending into the expanded sella abutting bilateral cavernous sinuses which was also visualized on a dotatate PET scan. The patient denied any changes in visual acuity, headache, nausea, vomiting, weakness, sensory deficits, seizure-like activity or lethargy. At the time of her second surgery, the differential considered was broad including possible inflammatory etiologies or hypophysitis given rapid onset of this lesion.
