Pituitary abscess showing high uptake of thallium-201 on single photon emission computed tomography--case report.
A 32-year-old female presented with a rare case of pituitary abscess manifesting as homonymous hemianopsia. Serum prolactin level was slightly high (40.8 ng/ml). Magnetic resonance (MR) imaging showed the content of the lesion as homogeneously isointense on the T1-weighted images and hyperintense on the T2-weighted images. The capsule of the lesion, which appeared thin and smooth, was enhanced by gadolinium. Dural enhancement around the sella turcica was also recognized. Thallium-201 single photon emission computed tomography (201Tl SPECT) showed homogeneous high accumulation in the pituitary region on both the early and delayed images. The lesion was treated via a transnasaltranssphenoidal approach. The cystic lesion contained pus and the capsule consisted of normal pituitary gland with inflammatory changes. The patient was treated with antibiotics for 3 weeks and the pituitary abscess was cured completely. Pituitary abscess can be differentiated from pituitary adenoma as lesion with a homogeneous high uptake on 201Tl SPECT on both the early and delayed images, and no enhancement of the central portion on MR images.
Shimamura
Norihito
N
Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan. shimab@cc.hirosaki-u.ac.jp
Ogane
Kazumi
K
Takahashi
Toshio
T
Tabata
Hidefumi
H
Ohkuma
Hiroki
H
Suzuki
Shigeharu
S
D000328:Adult; D001922:Brain Abscess / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005260:Female; D006801:Humans; D010900:Pituitary Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism*; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes / Q000493:pharmacokinetics*
D013794:Thallium Radioisotopes