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Aspergillus pituitary abscess.

A C Iplikcioglu1, S Bek, K Bikmaz

  • 1Neurosurgery Clinic, Social Security Okmeydani Teaching Hospital, Istanbul, Turkey. acelal@doctor.com

Acta Neurochirurgica
|May 1, 2004
PubMed
Summary

Fungal pituitary abscess is rare, with only five prior cases. This report details an Aspergillus pituitary abscess successfully treated with surgery and antifungal therapy, emphasizing histopathology for diagnosis.

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Area of Science:

  • Neurology
  • Mycology
  • Endocrinology

Background:

  • Pituitary abscess is a rare condition, predominantly bacterial.
  • Fungal pituitary abscesses, particularly Aspergillus, are exceptionally rare, with only five previous cases documented.
  • Intracranial aspergillosis carries a high mortality rate, especially in immunocompromised individuals.

Observation:

  • A 42-year-old male presented with a sellar-suprasellar mass, headache, and visual disturbances.
  • Neurological examination revealed papilledema and bitemporal hemianopsia.
  • Magnetic resonance imaging (MRI) suggested a pituitary abscess or adenoma.

Findings:

  • Histopathological examination confirmed Aspergillus pituitary abscess.
  • The patient underwent successful transsphenoidal surgery and received amphotericin-B treatment.
  • Two-year follow-up showed the patient was symptom-free with normal pituitary function.

Implications:

  • Aspergillus pituitary abscess should be considered in the differential diagnosis of pituitary masses.
  • Histopathological examination is crucial for definitive diagnosis, as imaging and cultures can be misleading or delayed.
  • Prompt surgical intervention and intensive antifungal therapy are essential for successful treatment and improved outcomes.

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