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[Three cases of pituitary abscess].
Y Osaka1, Y Horikawa, Y Nakahara
1Department of Neurosurgery, Kyoto Prefectural Yosanoumi Hospital, Japan.
No Shinkei Geka. Neurological Surgery
|September 14, 2001
Summary
Diagnosing pituitary abscesses is challenging, especially without inflammatory signs. Careful radiological evaluation, including MRI findings, is crucial for identifying these rare sellar masses.
Area of Science:
- Endocrinology
- Neurosurgery
- Radiology
Background:
- Pituitary abscesses are rare infections of the pituitary gland.
- Diagnosis can be challenging due to non-specific symptoms and lack of inflammatory markers.
Observation:
- Three female patients presented with headache and fatigue.
- Magnetic resonance imaging (MRI) revealed sellar masses with suprasellar extension, characterized by ring-enhancement.
- One case showed a progression from a hemorrhagic to a cystic lesion with ring-enhancement.
Findings:
- Transsphenoidal surgery was performed, but no organisms or tumor components were identified.
- Absence of inflammatory signs complicated pre-operative diagnosis.
- Specific MRI findings, including a cystic mass with ring-enhancement, thickened stalk, hyperprolactinemia, and diabetes insipidus, may suggest pituitary abscess.
Implications:
- Highlights the diagnostic difficulty of pituitary abscesses, particularly in the absence of overt inflammation.
- Emphasizes the critical role of detailed radiological assessment, especially MRI, in suspecting this condition.
- Suggests specific imaging and clinical features that warrant consideration for pituitary abscess in differential diagnosis.