J Korean Neurosurg Soc.  1997 Sep;26(9):1292-1296.

A Case of Pituitary Abscess

Affiliations
  • 1Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea.
  • 2Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Korea.

Abstract

A 35-year-old woman presented with amenorrhea, polydipsia, polyuria, general weakness and intolerance of cold; the duration of these symptoms had been five years. On brain MRI with Gadolinium enhancement, an intrasellar mass protruding above the sella turcica was demonstrated, and the patient was thought to be a pituitary adenoma. The transsphenoid approach(TSA) was employed, and during at surgery, pus was drained. In a culture of this, no microorganism was identified, and on histologic examination, which suggested lymphocytic infiltration with fibrosis and occasional neutrophils were seen, findings which suggested the possibility of capsule of chronic abscess. Transient postoperative polyuria was noted, but this disappreared soon after broad spectrum antibiotics were administered; hormonal therapy was required for anterior and posterior pituitary hypofunction. Clinical features of this condition and its treatment are also discussed, and the literature pertaining to reported cases is reviewed. An enlarged or erosive sella coexisting with bacterial meningitis, sphenoid sinusitis, cavernous sinus thrombophlebitis or bacterial meningitis coincident with a known or suspected pituitary tumor suggests the presence of a pituitary abscess.

Keyword

Pituitary abscess; Pituitary tumor; Brain MRI; Transsphenoidal approach; AntibioticP

MeSH Terms

Abscess*
Adult
Amenorrhea
Anti-Bacterial Agents
Brain
Cavernous Sinus Thrombosis
Female
Fibrosis
Gadolinium
Humans
Magnetic Resonance Imaging
Meningitis, Bacterial
Neutrophils
Pituitary Neoplasms
Polydipsia
Polyuria
Sella Turcica
Sphenoid Sinus
Sphenoid Sinusitis
Suppuration
Anti-Bacterial Agents
Gadolinium
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