1. Pituitary abscess occurring 12 years after transsphenoidal surgery for Rathke's cleft cyst
- Author
-
Hisato Ishii, MD, Shin Ito, MD, Shinichiro Teramoto, MD, Natsuki Sugiyama, MD, Hideaki Ueno, MD, and Satoshi Tsutsumi, MD
- Subjects
Pituitary abscess ,Rathke's cleft cyst ,Transsphenoidal surgery ,Late infection ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
A 73-year-old man who previously underwent transsphenoidal surgery for a Rathke's cleft cyst presented with headache and fever. Ophthalmological examination revealed the progression of visual impairment. Cerebral magnetic resonance imaging revealed a cystic mass in the sellar and suprasellar regions with rim-like enhancement. An intralesional hyperintense area with temporal enlargement was identified using serial diffusion-weighted imaging. Lumbar cerebrospinal fluid tap findings indicated bacterial meningitis. The patient had undergone a transsphenoidal surgery; an intraoperatively implanted sheet of artificial dura mater from the previous surgery was identified adjacent to the sellar floor. After incising the floor, the pus material was drained and methicillin-sensitive Staphylococcus aureus was identified on culture. Consecutive antibiotic treatment resolved the pituitary abscess (PA). PA may develop as a late complication of transsphenoidal surgery, particularly when an artificial material is implanted during surgery. Clinical signs coupled with temporal findings on diffusion-weighted sequences can facilitate the diagnosis and activity of PA and serve as a guide for proper management.
- Published
- 2024
- Full Text
- View/download PDF