[Recurrent cystic "hypophyseal abscess"]

A report is given on a primary hypophyseal abscess with an acute chiasmal syndrome, the only case among 426 hypophyseal interventions. In spite of two pterional exposures a relapse occurred, so that in the third operation a transethmoideo-sphenoid access was chosen. In this procedure--as the method of choice--a drainage into the paranasal sinuses is reached. The genesis is discussed on the basis of the histological findings, assuming differential-diagnostically a Rathke's cyst as the starting point.