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Pituitary abscess: our experience with a case and a review of the literature

Rinkoo Dalan1, Melvin Khee Shing Leow

  • 1Department of Endocrinology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. rinkoo99@yahoo.com

Pituitary
|June 28, 2007
PubMed

Insights

Pituitary abscess is a rare but serious condition often misdiagnosed as a pituitary macroadenoma. Early recognition is crucial to prevent severe complications like pituitary dysfunction.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Pituitary abscess is a rare condition with high mortality and morbidity.
  • Sellar masses can be challenging to diagnose preoperatively, even with advanced imaging.
  • Misdiagnosis of pituitary abscess as pituitary macroadenoma can lead to delayed treatment.

Observation:

  • A 45-year-old male presented with a six-month history of severe headache.
  • MRI revealed a sellar mass with peripheral enhancement, initially misdiagnosed as pituitary macroadenoma.
  • Surgical exploration via trans-sphenoidal excision unexpectedly revealed pus, indicating an abscess.

Findings:

  • Fungal and bacterial cultures from the drained pus were negative.
  • The patient developed complete pituitary gland failure, including central diabetes insipidus.
  • Permanent hormonal replacement therapy was required for multiple deficient endocrine axes.

Implications:

  • Pituitary abscess should be strongly considered in the differential diagnosis of sellar masses, even with typical imaging features of adenoma.
  • Prompt surgical drainage and appropriate management are critical to mitigate severe endocrine sequelae.
  • Further research into diagnostic markers and treatment strategies for pituitary abscess is warranted.

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