Pituitary tuberculosis in the pediatric population: a systematic review and case report.

PURPOSE: This review aims to identify and evaluate the management options for pituitary tuberculosis in the pediatric population.

METHODS: The study was conducted based on a comprehensive literature review using the PubMed, Cochrane Library, and ScienceDirect electronic databases. The following keywords were used: pituitary gland and tuberculosis or sellar tuberculoma and children or pediatric or adolescent. We limited the results to publications from 2014 to 2025. The study is a systematic review supplemented by a new case presentation.

RESULTS: Eight publications containing reports of 8 children with sellar/suprasellar tuberculosis were included to the review. The clinical data, including sex, age at diagnosis, country of origin, symptoms, endocrine disturbances, intracranial location, MRI findings, and treatment, were analyzed. The study was supplemented by a new case presentation in our department. Out of the 9 patients, 6 were female and 3 were male. The mean age was 10.6 years (with the range between 2 and 17 years).

CONCLUSIONS: Despite undeniable advances in medicine, the development of diagnostic and therapeutic methods, and the use of prophylactic vaccination, BCG (Bacillus Calmette-Guérin) tuberculosis is still a huge healthcare problem. Intrasellar tuberculoma presents a diagnostic challenge for clinicians since it mimics a pituitary adenoma and, therefore, should be included in the differential diagnosis. The lack of clinical and radiological data on tuberculosis, does not rule out the diagnosis of pituitary tuberculosis. The gold standard for the diagnosis of pituitary tumors is a biopsy, performed by a minimally invasive transsphenoidal approach. A delayed diagnosis may lead to permanent endocrine dysfunction. Regular follow-ups are crucial for evaluating the patient's hormone profile and may require lifelong hormone replacement.