Pituitary abscess: a report of two cases

Area of Science:

• Endocrinology
• Neurosurgery
• Infectious Diseases

Background:

• Pituitary abscess (PA) is a rare but potentially life-threatening infection located within the sella turcica.
• Diagnosis and management of PA can be challenging due to its infrequent occurrence and nonspecific symptoms.

Observation:

• Two cases of PA are presented: one in a patient with a history of a pituitary cyst and another following surgery for a pituitary macroadenoma.
• Both patients presented with sellar/suprasellar masses on MRI, which upon surgical exploration, yielded purulent material.
• Case 1 cultures identified Klebsiella Ozaenae; Case 2 required repeat decompression due to persistent lesion and worsening visual acuity.

Findings:

• Pituitary abscesses can mimic other sellar pathologies, complicating diagnosis.
• Recurrence or persistence of the abscess may occur even after surgical intervention.
• Infectious agents like Klebsiella Ozaenae can be causative agents.

Implications:

• These cases underscore the importance of considering PA in the differential diagnosis of sellar masses, especially in patients with relevant history.
• Effective management may require a multidisciplinary approach involving endocrinologists, neurosurgeons, and infectious disease specialists.
• Further research into optimal diagnostic and therapeutic strategies for pituitary abscess is warranted.