1. A rare case of a secondary pituitary abscess arising in a craniopharyngioma with atypical presentation and clinical course.
- Author
-
López Gómez P, Mato Mañas D, Bucheli Peñafiel C, Rodríguez Rodríguez EM, Pazos Toral FA, Obeso Aguera S, Viera Artiles J, Yange Zambrano G, Marco de Lucas E, and Martín Láez R
- Subjects
- Female, Humans, Magnetic Resonance Imaging, Middle Aged, Brain Abscess diagnostic imaging, Brain Abscess etiology, Craniopharyngioma complications, Craniopharyngioma diagnostic imaging, Craniopharyngioma surgery, Pituitary Diseases diagnosis, Pituitary Diseases pathology, Pituitary Diseases surgery, Pituitary Neoplasms complications, Pituitary Neoplasms diagnostic imaging, Pituitary Neoplasms surgery
- Abstract
Pituitary abscesses are very uncommon. They are divided into primary, arising within a healthy gland, and secondary, observed with an underlying pre-existing lesion. Here we present the eighth case reported of a secondary abscess within a craniopharyngioma. A 59-year-old-woman presented with a 3-week history of headache, and fever. Physical examination was unremarkable. An Magnetic Resonance Imaging (MRI) showed a pituitary lesion suggestive of a chronic inflammatory process. She was diagnosed with lymphocytic meningitis with hypophysitis and she was treated with corticosteroids. Two months later she presented with headache and fever again. Control MRI showed enlargement of the pituitary lesion. Therefore, a transsphenoidal biopsy was performed. During the procedure, purulent material was released. Histological study demonstrated a craniopharyngioma and meningeal inflammation. Empiric antibiotics were started. Three months post-operatively, a follow-up MRI showed a suspect minimal residual mass. Secondary pituitary abscesses are rare. The key to successful management is a high index of suspicion. Transsphenoidal surgical evacuation plus antibiotics is the mainstay of treatment. Although most symptoms resolve, endocrinopathies improve only rarely., (Copyright © 2021 Sociedad Española de Neurocirugía. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF