Endoscopic treatment of pituitary abscess: two case reports and literature review.
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.
Ciappetta
Pasqualino
P
Section of Neurosurgery, Department of Neurological Sciences, University of Bari Medical School, Piazza Giulio Cesare, 11, 70124 Bari, Italy.
Calace
Antonio
A
D'Urso
Pietro Ivo
PI
De Candia
Nicola
N
D000038:Abscess / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004724:Endoscopy; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures; D010900:Pituitary Diseases / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery; D015175:Prolactinoma / Q000150:complications / Q000601:surgery; D011512:Proteus Infections / Q000382:microbiology; D011513:Proteus mirabilis; D011552:Pseudomonas Infections / Q000382:microbiology
D000900:Anti-Bacterial Agents