Pituitary

, Volume 11, Issue 1, pp 89–92 | Cite as

Pituitary abscess: a report of two cases

  • Karina Danilowicz
  • Carlos Francisco Sanz
  • Marcos Manavela
  • Reynaldo Manuel Gomez
  • Oscar Domingo Bruno
Case Report

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.

Keywords

Pituitary Abscess Hypopituitarism 

References

  1. 1.
    Simmonds M (1914) Zur pathologic der hypophysis. Verh Disch Pathol 17:208–212Google Scholar
  2. 2.
    Hanel RA, Koerbel A, Prevedello DM, Moro MS, Aroiyo JC (2002) Primary pituitary simmonds abscess. Arq Neuropsiquiatr 60:1–7Google Scholar
  3. 3.
    Jain KC, Varma A, Mahapatra AK (1997) Pituitary abscess: a series of six cases. British J Neurosurg 11(2):139–143CrossRefGoogle Scholar
  4. 4.
    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) 118:327–329Google Scholar
  5. 5.
    Scanarini M, Cervellini P, Rigobello L, Mingrino S (1980) Pituitary abscesses: report of two cases and review of the literature. Acta Neurochir (Wien) 51:209–217CrossRefGoogle Scholar
  6. 6.
    Vates GE, Berger MS, Wilson CB (2001) Diagnosis and management of pituitary abscess: a review of twenty-four cases. J Neurosurg 95:233–241PubMedCrossRefGoogle Scholar
  7. 7.
    Blackett PR, Bailey JD, Hoffman HJ (1980) A pituitary abscess simulating an intrasellar tumor. Surg Neurol 14:129–131PubMedGoogle Scholar
  8. 8.
    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 9:267–273PubMedCrossRefGoogle Scholar
  9. 9.
    Maartens NF, Ellegala DB, Lopes MBS (2001) Pituitary abscess, letter to the editor. J Neurosurg 95:1110–1112PubMedGoogle Scholar
  10. 10.
    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 39:499–503PubMedCrossRefGoogle Scholar
  11. 11.
    Wilson CB, Boggan JE (1985) Pituitary abscesses. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill Book Company, London, pp 1967–1969Google Scholar
  12. 12.
    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 76:1499–1504PubMedCrossRefGoogle Scholar
  13. 13.
    Iplikcioglu AC, Bek S, Bikmaz K, Ceylan D, Gokduman CA (2004) Aspergillus pituitary abscess. Acta Neurochir (Wien) 146:521–524CrossRefGoogle Scholar
  14. 14.
    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 58:550–553PubMedGoogle Scholar
  15. 15.
    Berger SA, Pollock AA, Richmond S (1977) Isolation of Klebsiella ozaenae and Klebsiella rhinoscleromatosis in a general hospital. Am J Clin Pathol 67:499–502PubMedGoogle Scholar
  16. 16.
    Strampfer MJ, Schoch PE, Cunha BA (1987) Cerebral abscess caused by Klebsiella ozaenae. J Clin Microbiol 25(8):1553–1554PubMedGoogle Scholar
  17. 17.
    Bjerre P, Riishede J, Lindholm J (1983) Pituitary abscess. Acta Neurochir 68:187–193CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Karina Danilowicz
    • 1
  • Carlos Francisco Sanz
    • 1
  • Marcos Manavela
    • 1
  • Reynaldo Manuel Gomez
    • 1
  • Oscar Domingo Bruno
    • 1
  1. 1.Division of EndocrinologyHospital de ClínicasBuenos AiresArgentina

Personalised recommendations