Tumor-like hypophysitis is an uncommon sellar condition that presents as inflammatory lesions on the structures of the pituitary gland.Diagnosis and management of hypophysitis poses a significant challenge because its clinical manifestation and imaging presentation is difficult to distinguish with pituitary tumors.In this retrospective study,we summarise two rare cases of primary granulomatous hypophysitis,two cases of lymphocytic hypophysitis,and three cases of hormone replacement therapy without pathologic diagnosis.The mean age of the patients was 45.71±22.16 years,and there were two male and five female cases.The clinical signs included headache,fever,gradual decrease in visual acuity,nausea and vomiting.Enhanced magnetic resonance imaging (MRI) scans revealed sellar lesions with homo-or hypodense signals on the T1-weighted image and pituitary stalk.We performed a transsphenoidal surgery in three cases.The diagnosis of hypophysitis was difficult because it has no significant specific clinical signs.A transsphenoidal biopsy with fast-frozen pathology can diagnosis hypophysitis.Glucocorticoid therapy should be seriously considered for cases of hypophysitis,as complete removal of the pituitary masses can functionally disable the pituitary.Tumor-like hypophysitis is an uncommon sellar condition that presents as inflammatory lesions on the structures of the pituitary gland.Diagnosis and management of hypophysitis poses a significant challenge because its clinical manifestation and imaging presentation is difficult to distinguish with pituitary tumors.In this retrospective study,we summarise two rare cases of primary granulomatous hypophysitis,two cases of lymphocytic hypophysitis,and three cases of hormone replacement therapy without pathologic diagnosis.The mean age of the patients was 45.71±22.16 years,and there were two male and five female cases.The clinical signs included headache,fever,gradual decrease in visual acuity,nausea and vomiting.Enhanced magnetic resonance imaging (MRI) scans revealed sellar lesions with homo-or hypodense signals on the T1-weighted image and pituitary stalk.We performed a transsphenoidal surgery in three cases.The diagnosis of hypophysitis was difficult because it has no significant specific clinical signs.A transsphenoidal biopsy with fast-frozen pathology can diagnosis hypophysitis.Glucocorticoid therapy should be seriously considered for cases of hypophysitis,as complete removal of the pituitary masses can functionally disable the pituitary.