Pituitary abscess: our experience with a case and a review of the literature.
Pituitary abscess is a rare disease. Due to its potentially high mortality and morbidity rate, it should be considered in the differential diagnosis of sellar masses. Despite recent advances in radiological investigations, making a definitive diagnosis preoperatively remains challenging. This 45-year-old Indian gentleman presented with severe throbbing headache for six months. Magnetic resonance imaging of the brain revealed a sellar mass with peripheral enhancement that was misdiagnosed as a pituitary macroadenoma. A trans-sphenoidal excision was done, which surprisingly yielded only pus that was drained accordingly from the lesion. Fungal and bacterial cultures were negative. However this patient subsequently lost complete function of the pituitary gland, resulting in central diabetes insipidus and required permanent hormonal replacement therapy in the deficient endocrine axes. A Medline search was conducted and a review of 24 cases reported in the last 5 years discussed.
Dalan
Rinkoo
R
Department of Endocrinology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. rinkoo99@yahoo.com
Leow
Melvin Khee Shing
MK
D000038:Abscess / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis*; D020790:Diabetes Insipidus, Neurogenic / Q000188:drug therapy / Q000209:etiology; D003951:Diagnostic Errors; D004322:Drainage; D006261:Headache / Q000209:etiology; D020249:Hormone Replacement Therapy; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010901:Pituitary Function Tests; D010911:Pituitary Neoplasms / Q000175:diagnosis*