Neurosurgical Review

, Volume 31, Issue 2, pp 237–246

Endoscopic treatment of pituitary abscess: two case reports and literature review

Authors

  • Pasqualino Ciappetta
    • Section of Neurosurgery, Department of Neurological SciencesUniversity of Bari Medical School
  • Antonio Calace
    • Section of Neurosurgery, Department of Neurological SciencesUniversity of Bari Medical School
    • Section of Neurosurgery, Department of Neurological SciencesUniversity of Bari Medical School
  • Nicola De Candia
    • Otorhinolaryngoiatry Clinic, Department of Ophthalmology and OtorhinolaryngologyUniversity of Bari Medical School
Case Report

DOI: 10.1007/s10143-007-0096-2

Cite this article as:
Ciappetta, P., Calace, A., D’Urso, P.I. et al. Neurosurg Rev (2008) 31: 237. doi:10.1007/s10143-007-0096-2

Abstract

Pituitary abscess is a rare entity and the correct diagnosis is still difficult before surgery. More than 210 cases have been reported in the medical literature, mostly in the form of isolated case reports. We report two cases of pituitary abscess treated endoscopically and we review the literature. A 30-year-old woman and a 35-year-old man were admitted with a history of pituitary dysfunction. Patient 1 presented with polyuria, polydipsia, amenorrhea, headache, and visual impairment. Magnetic resonance imaging showed a cystic intra- and supra-sellar lesion with ring enhancement after contrast injection. Patient 2 presented with frontal headache, proptosis, painful ophthalmoplegia, visual impairment, and fever. Eight years before the patient had undergone a transphenoidal surgery for Prolactinoma. Magnetic resonance imaging revealed a sellar lesion extending into the cavernous sinus and carotid artery bilaterally. Both patients underwent endoscopic transnasal-transsphenoidal exploration. Intraoperative diagnosis of pituitary abscess was made. The postoperative courses were uneventful. Antibiotic therapy was performed in both cases. Only three cases of endoscopic treatment of pituitary abscess have been reported in the literature. We recommend early management by endoscopic transphenoidal surgery for pituitary abscess: this technique is safe, with minimal blood loss, short operating time, low morbidity, and brief hospital stay.

Keywords

Endoscopic transsphenoidal surgeryNasal polyposisPituitary abscessPituitary adenoma

Copyright information

© Springer-Verlag 2007