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Updated: Nov 9, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Secondary Pituitary Abscess from Mite
Yao-Chung Yang1, Wei-Chuan Liao2
1Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Abstract:
A 30-year-old woman experienced nasal stuffiness followed by a progressive headache and reduced visual acuity for 3 weeks. She underwent an endoscopic endonasal transsphenoidal approach for pituitary spindle cell oncocytoma 13 months before the present admission. Magnetic resonance imaging revealed an intrasellar cystic lesion with a suprasellar extension. After endoscopic endonasal transsphenoidal approach for tumor removal, the histologic findings of inflammatory infiltration showed a pituitary abscess. Microscopy revealed mites and fungal hyphae. Cultures from the abscess showed Staphylococcus hyicus, Stenotrophomonas maltophilia, and Aspergillus sp. The patient received a 6-week antibiotic treatment, which completely resolved the clinical symptoms and cleared the magnetic resonance imaging findings.
Insights
A pituitary abscess, initially misdiagnosed as a tumor recurrence, was successfully treated with antibiotics. This case highlights the importance of considering infectious causes in post-operative pituitary lesions.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- A patient presented with symptoms suggestive of pituitary tumor recurrence, including nasal stuffiness, headache, and vision loss.
- The patient had a history of pituitary spindle cell oncocytoma treated via endoscopic endonasal transsphenoidal approach 13 months prior.
- Imaging revealed an intrasellar cystic lesion with suprasellar extension, mimicking tumor recurrence.
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