Abstract
Pituitary abscess (PA) is an infrequent disease, which consists of an infection within the sella turcica that might be life-threatening. We present here two cases of this rare entity. Case 1: A 53-year-old woman was followed for an incidentally found pituitary cyst. Six years later the cyst enlarged and transsphenoidal surgery was performed. Two years later, the patient developed sudden onset of intense headache and nausea. The MRI showed a 2 by 2.5 cm sellar and suprasellar mass, that enhanced peripherally with gadolinium contrast and became hyperintense in T2-weighted images, suggesting a new-onset cystic lesion. During transsphenoidal surgery, large amounts of purulent material were drained from the sella. The cultures were positive for Klebsiella Ozaenae. Case 2: A 63-year-old woman, 4 years after transsphenoidal resection of a GH-secreting macroadenoma, developed a new sellar 2.6 cm cystic mass. On re-operation, purulent material was drained from the sella. The lesion persisted on the MRI and visual acuity worsened so a repeat pituitary decompression was carried out 6 months later, obtaining the same pathological results. Three years later, the MRI still shows the same mass. She feels well and her physical examination and clinical history are unremarkable. These cases illustrate the difficulties in the diagnosis and management of this rare entity.
References
Simmonds M (1914) Zur pathologic der hypophysis. Verh Disch Pathol 17:208–212
Hanel RA, Koerbel A, Prevedello DM, Moro MS, Aroiyo JC (2002) Primary pituitary simmonds abscess. Arq Neuropsiquiatr 60:1–7
Jain KC, Varma A, Mahapatra AK (1997) Pituitary abscess: a series of six cases. British J Neurosurg 11(2):139–143
Verdalle P, Roquet E, Hor F, Raynal M, Courtois A, Bauduceau B, Pharaboz C, Poncet JL (1997) Pituitary abscess: a rare complication of sinusitis. Rev Laryngol Otol Rhinol (Bord) 118:327–329
Scanarini M, Cervellini P, Rigobello L, Mingrino S (1980) Pituitary abscesses: report of two cases and review of the literature. Acta Neurochir (Wien) 51:209–217
Vates GE, Berger MS, Wilson CB (2001) Diagnosis and management of pituitary abscess: a review of twenty-four cases. J Neurosurg 95:233–241
Blackett PR, Bailey JD, Hoffman HJ (1980) A pituitary abscess simulating an intrasellar tumor. Surg Neurol 14:129–131
Dutta P, Bhansali A, Singh P, Kotwal N, Pathak A, Kumar Y (2006) Pituitary abscess: report of four cases and review of the literature. Pituitary 9:267–273
Maartens NF, Ellegala DB, Lopes MBS (2001) Pituitary abscess, letter to the editor. J Neurosurg 95:1110–1112
Wolansky LJ, Gallagher JD, Heary RF, Malantic GP, Dasmahapatra A, Shaderowfsky PD, Budhwani N (1997) MRI of pituitary abscess: two cases and review of the literature. Neuroradiology 39:499–503
Wilson CB, Boggan JE (1985) Pituitary abscesses. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill Book Company, London, pp 1967–1969
Ahmed SR, Aiello DP, Page R, Hopper K, Towfighi J, Santen RJ (1993) Necrotizing infundibulo-hypophysitis: a unique syndrome of diabetes insipidus and hypopituitarism. J Clin Endocrinol Metab 76:1499–1504
Iplikcioglu AC, Bek S, Bikmaz K, Ceylan D, Gokduman CA (2004) Aspergillus pituitary abscess. Acta Neurochir (Wien) 146:521–524
Malowany MS, Chester B, Allerhand J (1972) Isolation and microbiologic differentiation of Klebsiella rhinoscleromatosis and Klebsiella ozaenae in cases of chronic rhinitis. Am J Clin Pathol 58:550–553
Berger SA, Pollock AA, Richmond S (1977) Isolation of Klebsiella ozaenae and Klebsiella rhinoscleromatosis in a general hospital. Am J Clin Pathol 67:499–502
Strampfer MJ, Schoch PE, Cunha BA (1987) Cerebral abscess caused by Klebsiella ozaenae. J Clin Microbiol 25(8):1553–1554
Bjerre P, Riishede J, Lindholm J (1983) Pituitary abscess. Acta Neurochir 68:187–193
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Danilowicz, K., Sanz, C., Manavela, M. et al. Pituitary abscess: a report of two cases. Pituitary 11, 89–92 (2008). https://doi.org/10.1007/s11102-007-0033-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11102-007-0033-y