RSS-Feed abonnieren
DOI: 10.1055/a-2297-3909
Primary Pituitary Abscess: Two Case Reports
Abstract
Introduction Pituitary abscess is a rare disorder that represents a small fraction of all pituitary lesions. In this report, we present two additional cases with unique features to promote awareness and prompt surgical intervention.
Case Presentations A 42-year-old male presented with headache, photophobia, subjective fever, dizziness, imbalance, nausea, and vomiting. A pituitary hormone panel confirmed hypothyroidism and suggested central hypogonadism and secondary adrenal insufficiency. Magnetic resonance imaging (MRI) showed a large sellar mass measuring 2.5 cm × 1.8 cm × 1.6 cm (CC × XT × AP). A 76-year-old woman presented with several months of headaches and unsteady gait in the setting of a known previously asymptomatic sellar lesion, measuring 1.8 cm × 1.2 cm × 1.5 cm (XT × CC × AP). Repeat MRI demonstrated possible hemorrhage within the lesion. In both cases, a preliminary diagnosis of pituitary macroadenoma was made, but transsphenoidal surgery revealed an encapsulated abscess; cultures obtained from the abscesses stained for gram-positive bacteria.
Conclusion Pituitary abscess is a rare, potentially life-threatening disorder that may be easily mistaken for other sellar lesions. In this review, we contribute two additional cases of pituitary abscesses to increase awareness and emphasize the importance of proper diagnosis and management.
Publikationsverlauf
Eingereicht: 28. September 2022
Angenommen: 21. Oktober 2023
Accepted Manuscript online:
01. April 2024
Artikel online veröffentlicht:
25. April 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Stringer F, Foong YC, Tan A. et al. Pituitary abscess: a case report and systematic review of 488 cases. Orphanet J Rare Dis 2023; 18 (01) 165
- 2 Cabuk B, Caklılı M, Anık I, Ceylan S, Celik O, Ustün C. Primary pituitary abscess case series and a review of the literature. Neuroendocrinol Lett 2019; 40 (02) 99-104
- 3 Liu F, Li G, Yao Y. et al. Diagnosis and management of pituitary abscess: experiences from 33 cases. Clin Endocrinol (Oxf) 2011; 74 (01) 79-88
- 4 Bodey G, Bueltmann B, Duguid W. et al. Fungal infections in cancer patients: an international autopsy survey. Eur J Clin Microbiol Infect Dis 1992; 11 (02) 99-109
- 5 Domingue JN, Wilson CB. Pituitary abscesses. Report of seven cases and review of the literature. J Neurosurg 1977; 46 (05) 601-608
- 6 Jain KC, Varma A, Mahapatra AK. Pituitary abscess: a series of six cases. Br J Neurosurg 1997; 11 (02) 139-143
- 7 Post KD, McCormick PC, Bello JA. Differential diagnosis of pituitary tumors. Endocrinol Metab Clin North Am 1987; 16 (03) 609-645
- 8 Gao L, Guo X, Tian R. et al. Pituitary abscess: clinical manifestations, diagnosis and treatment of 66 cases from a large pituitary center over 23 years. Pituitary 2017; 20 (02) 189-194
- 9 Vates GE, Berger MS, Wilson CB. Diagnosis and management of pituitary abscess: a review of twenty-four cases. J Neurosurg 2001; 95 (02) 233-241
- 10 Shkarubo AN, Chernov IV, Pronin IN, Agrba SB, Andreev DN, Sinelnikov MY. Primary sellar abscesses: a systematic review and 2 rare observations. World Neurosurg 2021; 154: 21-28
- 11 Ciappetta P, Calace A, D'Urso PI, De Candia N. Endoscopic treatment of pituitary abscess: two case reports and literature review. Neurosurg Rev 2008; 31 (02) 237-246 , discussion 246
- 12 Zhang X, Sun J, Shen M. et al. Diagnosis and minimally invasive surgery for the pituitary abscess: a review of twenty nine cases. Clin Neurol Neurosurg 2012; 114 (07) 957-961