Abstract
Introduction:
An association of Rosai-Dorfman disease (RDD) and pituitary adenoma has not been reported. In fact, RDD of the pituitary gland is uncommon. Here we report the first case of RDD following resection of a pituitary adenoma.
Methods:
The case history of a 49-year-old woman who had galactorrhea and a slightly elevated prolactin level due to stalk effect was reviewed. Trans-sphenoidal surgery revealed a nonfunctional pituitary adenoma. Postoperative diabetes insipidus was treated medically and persists. Work-up for trans-sphenoidal surgery also revealed a mediastinal mass, which at surgery was RDD of the thymus. Five months after initial trans-sphenoidal surgery the sellar tumor recurred and caused some optic nerve compression. The patient underwent a second trans-sphenoidal resection of tumor, which was in fact RDD involving the pituitary gland and adjacent sellar dura. Preoperative headaches improved. Adjuvant radiotherapy was declined by the patient due to fear of losing anterior pituitary function. Steroids were rapidly tapered.
Results:
Currently, 12 months after her second pituitary surgery, the patient has had no sellar or parasellar recurrence, and anterior pituitary function remains intact. The RDD has not recurred systemically and the original thymic location also shows no recurrence.
Conclusion:
We report the first case of RDD of the pituitary gland following resection of a nonsecreting pituitary adenoma. Resective surgery without radiotherapy has controlled local recurrence at 1 year of clinical and radiological follow-up.