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.