1/26. Pituitary abscess secondary to isolated sphenoid sinusitis.Intracranial complications from isolated sphenoid sinusitis are rare but nevertheless demonstrate both a high morbidity and mortality. We herein report a case of a pituitary abscess secondary to sphenoid sinusitis in a 12-year-old boy. This patient presented with an acute onset of moderate fever and headache, followed by progressive right ptosis. An emergency endoscopic endonasal sphenoidotomy with sinus drainage and postoperative antibiotic therapy resulted in a satisfactory recovery.- - - - - - - - - - ranking = 1keywords = pituitary (Clic here for more details about this article) |
2/26. Rathke's cleft cyst abscess.Pituitary abscesses are rare. Occasionally they will arise in pre-existing pituitary pathology. We report such an occurrence within a Rathke's cleft cyst. On the basis of history and imaging, this was indistinguishable from more commonly encountered pituitary pathology.- - - - - - - - - - ranking = 2keywords = pituitary (Clic here for more details about this article) |
3/26. Secondary abscess formation in pituitary adenoma after tooth extraction. Case report.The presence of an abscess in a pituitary tumor is a very rare finding. The authors report the case of a 69-year-old man with a pituitary adenoma confirmed by neuroimaging results, in whom a high fever, meningismus, and left-sided ophthalmoplegia developed 4 days after tooth extraction. The results of serial cranial magnetic resonance imaging were highly indicative of an abscess formation within the pituitary adenoma. During surgery the tumor was approached transsphenoidally and removed. Histological examination confirmed the presence of an abscess formation within the pituitary adenoma. It is most likely that the tooth extraction caused a bacteremia, which led to an inflammation with abscess formation within the pituitary adenoma. The authors conclude that invasive dental procedures should be avoided before planned resection of a pituitary adenoma.- - - - - - - - - - ranking = 10keywords = pituitary (Clic here for more details about this article) |
4/26. Pituitary abscess showing high uptake of thallium-201 on single photon emission computed tomography--case report.A 32-year-old female presented with a rare case of pituitary abscess manifesting as homonymous hemianopsia. serum prolactin level was slightly high (40.8 ng/ml). Magnetic resonance (MR) imaging showed the content of the lesion as homogeneously isointense on the T1-weighted images and hyperintense on the T2-weighted images. The capsule of the lesion, which appeared thin and smooth, was enhanced by gadolinium. Dural enhancement around the sella turcica was also recognized. thallium-201 single photon emission computed tomography (201Tl SPECT) showed homogeneous high accumulation in the pituitary region on both the early and delayed images. The lesion was treated via a transnasaltranssphenoidal approach. The cystic lesion contained pus and the capsule consisted of normal pituitary gland with inflammatory changes. The patient was treated with antibiotics for 3 weeks and the pituitary abscess was cured completely. Pituitary abscess can be differentiated from pituitary adenoma as lesion with a homogeneous high uptake on 201Tl SPECT on both the early and delayed images, and no enhancement of the central portion on MR images.- - - - - - - - - - ranking = 5keywords = pituitary (Clic here for more details about this article) |
5/26. A case of anterior hypopituitarism showing recurrent pituitary mass associated with central diabetes insipidus.We report a case of anterior hypopituitarism showing recurrent pituitary mass associated with central diabetes insipidus. A 76-year old woman was hospitalized with general fatigue and 5 kg body weight loss. Endocrinological examinations and pituitary provocative tests demonstrated hypopituitarism and central diabetes insipidus. T1-weighted image of magnetic resonance imaging (MRI) revealed an intrasellar cystic mass with ring enhancement suggesting pituitary abscess. MRI films subsequently obtained from another hospital and studied retrospectively showed intrasellar cystic mass with ring enhancement 4 years earlier, and a mass shape that was decreased after 2 years. Over the subsequent years, the patient has remained asymptomatic with hormone replacement therapy only. Cystic pituitary adenoma or Rathke's cleft cyst with repeated infection may be involved in the repeated change of pituitary mass shape although neither pituitary surgery nor a pituitary biopsy was performed because of the patient's age and condition. It is reported that apparent recurrence of Rathke's cleft cysts after initially successful surgery was higher than suggested by previous reports, and that long-term follow-up with pituitary imaging and neuroophthalmological assessment is essential. Careful evaluation by follow-up brain MRI is needed in the present case to prevent future recurrence of pituitary abscess.- - - - - - - - - - ranking = 13keywords = pituitary (Clic here for more details about this article) |
6/26. Bacterial pituitary abscess: an unusual cause of panhypopituitarism.OBJECTIVE: To describe a case of primary bacterial pituitary abscess manifesting as hypopituitarism. methods: We present the case history, hormonal and bacteriologic data, and findings on imaging studies in a 34-year-old man. RESULTS: The patient had an 8-month history of intermittent fever, headache, nausea, vomiting, and weight loss. Because a computed tomographic scan of the head showed a cystic sellar mass with ring enhancement, he was referred to our medical center. On physical examination, he showed signs of meningeal irritation and had mild hypotension. Hormonal evaluation revealed evidence of hypocortisolism, hypothyroidism, and hypogonadism. Three weeks after treatment with antibiotics and hormonal replacement, he underwent transsphenoidal surgical exploration and evacuation of purulent material from the sella. On culture, this specimen grew coagulase-negative staphylococci and propionibacterium granulosum. Nine months later, dynamic testing showed persistent central hypocortisolism, hypothyroidism, and hypogonadism. CONCLUSION: Bacterial pituitary abscess is rare but manifests similar to other pituitary masses with headaches, visual field defects, and hormonal disturbances. For the correct preoperative diagnosis of this condition, the physician must have a high index of suspicion, and the characteristic ring enhancement must be present on imaging studies.- - - - - - - - - - ranking = 7keywords = pituitary (Clic here for more details about this article) |
7/26. Pituitary abscess in a patient with painless thyroiditis.The preoperative diagnosis of pituitary abscess is difficult. The case of a 56-year-old man with a pituitary abscess and painless thyroiditis is presented. There has been no previous such report. The differential diagnosis includes pituitary abscess, lymphocytic adenohypophysitis or infundibuloneurohypophysitis, share clinical symptoms of panhypopituitarism and diabetes insipidus, and is of critical importance as the treatment of these conditions differ. The association with painless thyroiditis suggests a diagnosis of lymphocytic adenohypophysitis or infundibuloneurohypophysitis. However, the coincidence of pituitary abscess and painless thyroiditis was observed in our patient, and thus though rare, should be considered. Surgical exploration and histopathological examination are essential for the differential diagnosis of these diseases.- - - - - - - - - - ranking = 4keywords = pituitary (Clic here for more details about this article) |
8/26. Presumed pituitary abscess without infectious source treated successfully with antibiotics alone.A 12-year-old girl developed acute frontal headache and severe visual loss in both eyes. A presumptive diagnosis of pituitary abscess was made on the basis of suggestive magnetic resonance imaging findings. These consisted of a large non-enhancing area within the pituitary gland and thin irregular glandular rim enhancement. There was no evidence of pre-existing intracranial or systemic infection. The patient recovered completely after treatment with intravenous and oral antibiotics without surgical drainage. This case highlights the need for a high index of suspicion for pituitary abscess based on unusual imaging findings even when there is no source of infection.- - - - - - - - - - ranking = 7keywords = pituitary (Clic here for more details about this article) |
9/26. A pituitary abscess showing high signal intensity on diffusion-weighted imaging.The utility of diffusion-weighted imaging (DWI) for the diagnosis of intracranial abscesses has already been established. However, the use of DWI for pituitary abscesses has not been previously reported. We present a case of postoperative pituitary abscess in which T1-weighted and T2-weighted magnetic resonance imaging (MRI) revealed a supra-sellar cystic mass, with the cyst contents showing high intensity on DWI. This case suggests that DWI is useful for the diagnosis of pituitary abscesses.- - - - - - - - - - ranking = 7keywords = pituitary (Clic here for more details about this article) |
10/26. Intrasellar abscess simulating a pituitary tumour.A case of an abscess of the sella turcica discovered during craniotomy for pituitary tumour in a 20-year-old man is presented. The clinical features of this unusual intrasellar lesion are discussed. The importance of early diagnosis, high-dosage antibiotics and surgical intervention in reducing the high mortality associated with abscesses in this location are emphasized. It is suggested that abscess of the sella turcica should be considered in the differential diagnosis of a sella mass in any patient with a recent history of cerebrospinal fluid rhinorrhea, sphenoid sinusitis or meningitis.- - - - - - - - - - ranking = 5keywords = pituitary (Clic here for more details about this article) |
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