A pituitary abscess showing high signal intensity on diffusion-weighted imaging

Takayasu, Takeshi; Yamasaki, Fumiyuki; Tominaga, Atsushi; Hidaka, Toshikazu; Arita, Kazunori; Kurisu, Kaoru

doi:10.1007/s10143-006-0021-0

Cited by 41 publications

(31 citation statements)

References 10 publications

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“…The majority of the previously reported cases of RCC abscess have presented with clinical features typical of mass effect, namely; visual impairment, endocrine disturbance and headache [3]. Systemic features such as leukocytosis and pyrexia are atypical but may also manifest [3–5]. The majority of RCC abscesses seem to occur spontaneously, although previous pituitary surgery, irradiation of the gland and immunosuppressive therapy are speculated to be risk factors [1, 2].…”

Section: Discussionmentioning

confidence: 99%

Abscess formation within a Rathke's cleft cyst

Coulter

Mahmood

Scoones

et al. 2014

Journal of Surgical Case Reports

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We report and discuss the rare case of a pituitary abscess forming within a Rathke's cleft cyst (RCC). A 66-year-old gentleman presented with visual deterioration and symptoms suggestive of hypopituitarism. The patient underwent transsphenoidal debulking of the lesion whereupon purulent material was discovered. Histological examination was suggestive of RCC together with numerous neutrophils characteristic of abscess. Microbiological culture of the material grew Staphylococcus aureus. The patient was treated for a RCC abscess and received antibiotics and endocrine replacement therapy. The patient has been followed up for 2 years without recurrence. Although uncommon, we recommend the consideration of RCC abscess as a differential diagnosis of a pituitary mass lesion as clinical presentation and radiological assessment are not specific in identifying these lesions preoperatively.

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Section: Discussionmentioning

confidence: 99%

Abscess formation within a Rathke's cleft cyst

Coulter

Mahmood

Scoones

et al. 2014

Journal of Surgical Case Reports

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“…It was also reported that pituitary apoplexy occasionally demonstrates ring enhancement after gadolinium injection 1 . Pituitary abscess has also been reported to show high signal intensity on diffusion-weighted imaging (DWI) 1,17,18 . On the other hand, pituitary apoplexy also demonstrates high signal intensity on DWI due to ischemic injury or deposit of blood derived substances.…”

Section: Discussionmentioning

confidence: 96%

Unusual Presentation of Recurrent Pituitary Abscess

et al. 2010

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Pituitary abscess is a rare pituitary pathology which may be potentially life-threatening if not treated. Therefore, early accurate diagnosis and therapy are extremely important. However, the clinical diagnosis is difficult because there are no clinical symptoms characteristic of pituitary abscess. It is frequently indistinguishable clinically or with neuroimaging studies from other pituitary lesions. The MR diagnosis of pituitary abscess must be suspected in cases of sellar cystic mass with a peripheral rim enhancement after contrast administration. It must be highlighted that pituitary abscess may show various signal intensity on T1-weighted images, as in our case, making the diagnosis even more difficult. We report an unusual case of a 66-year-old woman who presented with a recurrent pituitary abscess, initially misdiagnosed as a pituitary adenoma because of its high signal intensity on T1-weighted images. The woman was operated on three times, using transsphenoidal access with a good final outcome.

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“…2,3,[7][8][9][12][13][14]16,17,19,[21][22][23][24]26) Twelve patients were female, seven were male, and the mean age of these patients was 44.1 years (range 12-69 years). Three were pediatric cases.…”

Section: Discussionmentioning

confidence: 99%

Pituitary Abscess Manifesting as Meningitis and Photophobia Associated With Rathke's Cleft Cyst in a Child -Case Report-

Uchiyama

Sakai

Asanuma

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 12-year-old girl presented with complaints of headache, lethargy, photophobia, and fever. Cerebrospinal fluid examination revealed bacterial meningitis. Magnetic resonance (MR) imaging showed a cystic lesion with peripheral enhancement in the pituitary fossa. The patient underwent transnasaltranssphenoidal surgery (TSS). The diagnosis was pituitary abscess associated with Rathke's cleft cyst. Postoperatively, the patient recovered rapidly. However, recurrence of the pituitary abscess causing meningitis occurred four times and required repeated TSS. She had diabetes insipidus and received hormone replacement. This case requiring repeated emergency surgeries shows that follow-up examinations including MR imaging and pituitary endocrine evaluation are necessary because the rate of recurrence is high in patients with pituitary abscess associated with Rathke's cleft cyst.

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A pituitary abscess showing high signal intensity on diffusion-weighted imaging

Cited by 41 publications

References 10 publications

Abscess formation within a Rathke's cleft cyst

Abscess formation within a Rathke's cleft cyst

Unusual Presentation of Recurrent Pituitary Abscess

Pituitary Abscess Manifesting as Meningitis and Photophobia Associated With Rathke's Cleft Cyst in a Child -Case Report-

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