Xanthogranulomatous hypophysitis masquerading as pituitary macroadenoma

Xanthogranulomatous hypophysitis (XGH) is an inflammatory disease of the pituitary gland that has clinical presentation and radiologic features similar to a neoplastic lesion. We report a rare case of XGH in an elderly male of 61-year-old age presenting with features of a pituitary macroadenoma with apoplexy. Clinical features and radiologic findings can be confusing and misleading. Surgical resection is the preferred method for treatment and establishing the final diagnosis from biopsy. Attention should be paid to the management of hypopituitarism and diabetes insipidus. Preoperative diagnosis is difficult and a high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.