Pituitary abscess

Rudwan, M. A.

doi:10.1007/bf00340017

Cited by 31 publications

(5 citation statements)

References 13 publications

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“…4,7,12,14,17,19,23,24,26,28) Recently, magnetic resonance (MR) imaging has shown that pituitary lesions are quite common, but pituitary abscess is rare. Two cases of pituitary abscess were identified intraoperatively in a series of 500 pituitary expansive lesions, 26) and a series of six cases of pituitary abscess accounted for 0.6% of total pituitary lesions.…”

Section: Introductionmentioning

confidence: 99%

Pituitary Abscess Showing High Uptake of Thallium-201 on Single Photon Emission Computed Tomography. Case Report.

Shimamura

Ogane

Takahashi

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 32-year-old female presented with a rare case of pituitary abscess manifesting as homonymous hemianopsia. Serum prolactin level was slightly high (40.8 ng/ml). Magnetic resonance (MR) imaging showed the content of the lesion as homogeneously isointense on the T 1 -weighted images and hyperintense on the T 2 -weighted images. The capsule of the lesion, which appeared thin and smooth, was enhanced by gadolinium. Dural enhancement around the sella turcica was also recognized. Thallium-201 single photon emission computed tomography ( 201 Tl SPECT) showed homogeneous high accumulation in the pituitary region on both the early and delayed images. The lesion was treated via a transnasaltranssphenoidal approach. The cystic lesion contained pus and the capsule consisted of normal pituitary gland with inflammatory changes. The patient was treated with antibiotics for 3 weeks and the pituitary abscess was cured completely. Pituitary abscess can be differentiated from pituitary adenoma as lesion with a homogeneous high uptake on 201 Tl SPECT on both the early and delayed images, and no enhancement of the central portion on MR images.

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Section: Introductionmentioning

confidence: 99%

Pituitary Abscess Showing High Uptake of Thallium-201 on Single Photon Emission Computed Tomography. Case Report.

Shimamura

Ogane

Takahashi

et al. 2003

Neurol. Med. Chir.(Tokyo)

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“…13,15,18,29 Microscopic identification of massive polymorphonuclear leukocytes or macrophages with underlying necrosis leads to the diagnosis of pituitary abscess. 18 However, as these microscopic findings may mimic those of pituitary tumor infarction 12,26,30 or necrotizing infundibuloneurohypophysitis, 11 examination of the cyst wall and the surrounding pituitary gland is important for the precise diagnosis. 11,18 Since the invention of antibiotics, pituitary abscess has become a treatable disease.…”

Section: Discussionmentioning

confidence: 98%

A Patient Presenting Partial Diabetes Insipidus Diagnosed as Pituitary Abscess With Paranasal Sinusitis

Matsuno¹,

Nakashima²,

Katayama³

et al. 2005

The Endocrinologist

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Pituitary abscess is a rare clinicopathological entity. Although many cases of pituitary abscess have been reported, the origin, etiology, and nature of this condition remain enigmatic. Furthermore, despite remarkable advances in medical technology, preoperative and histopathological diagnosis remains difficult. In this report, we described a 60-year-old patient with pituitary abscess presenting partial diabetes insipidus with paranasal sinusitis and focused on the necessity of surgical exploration of the surrounding pituitary tissue and histopathological confirmation for the precise diagnosis. Prolonged administration of antibiotics is recommended. (The Endocrinologist 2005;15: 10 -13)P ituitary abscess is a rare clinicopathological entity. Although over 200 cases of pituitary abscess have been reported since the early 19th century, the origin, etiology, and nature of this condition remain enigmatic. Furthermore, despite remarkable advances in medical technology, preoperative and histopathological diagnosis remains difficult. In this report, we described a patient of pituitary abscess presenting partial diabetes insipidus with paranasal sinusitis and focused on the necessity of surgical exploration and histopathological confirmation for the precise diagnosis. CASE REPORTA 60-year-old man complained of headache, thirst, polydipsia, and polyuria since August 2002. He was found to have a mass lesion in the pituitary gland and was admitted to our hospital on September 25, 2002. His urinary volume was 5800 to 6600 mL per day. He had a history of bilateral maxillary sinusitis. He was afebrile and free from visual symptoms, except for decreased visual acuity in the right eye due to cataract. General and neurologic examination revealed no abnormality; his body height was 161 cm, body weight 75 kg, blood pressure 140/70 mm Hg. Routine blood tests were normal; white blood cell count 5300, C-reactive protein (CRP) Ͻ0.3. Basal levels of pituitary and its related hormones were within normal values as follows: growth hormone (GH) 0.26 ng/mL (normal range: Ͻ0.42 ng/mL), prolactin (PRL) 4.3 ng/mL (1.5-9.7 ng/mL), luteinizing hormone (LH) 1.1 mIU/mL (0.2-20 mIU/mL) and folliculostimulating hormone (FSH) 3.8 mIU/mL (0.8-22.9 mIU/mL). His plasma adrenocorticotropic hormone (ACTH) and serum cortisol levels were normal, being 11.4 pg/mL (4-40 pg/mL) and 9.4 g/dL (4.0-18.3 g/dL), respectively. Serum TSH was 2.4 U/mL (0.34-3.5 U/mL), and free T4 and free T3 were 0.99 ng/dL (0.83-1.56 ng/dL) and 2.79 pg/mL (2.38-4.23 pg/mL), respectively. Intravenous injection of 500 g of thyrotropin releasing hormone increased serum TSH and PRL from 2.4 U/mL to 13.2 U/mL, from 5.5 ng/mL to 14.0 ng/mL; 100 g of gonadotropin releasing hormone loading increased serum FSH and LH from 3.2 mIU/mL to 10.0 mIU/mL, from 0.9 mIU/mL to 11.0 mIU/mL. One hundred micrograms of GH releasing hormone loading increased serum GH from 0.33 ng/mL to 15.2 ng/mL. One hundred micrograms of corticotropin releasing hormone loading increased plasma ACTH and serum cortisol from ...

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“…In most reported series, the diagnosis of pituitary abscess is not suspected pre-operatively (Hammann, 1955;Domingue and Wilson, 1977;Rudwan, 1977); however, in Nelson et al (1983) series of three cases of pituitary abscess which arose in association with pituitary adenomas, the diagnosis was suspected on the basis of enhancement of the sella mass.…”

Section: Discussionmentioning

confidence: 99%

“…On clinical grounds, the presence of an intra sellar abscess may be suspected in those patients who are thought to have pituitary tumours and who present with septic meningitis, especially if more than one attack of meningitis has occurred (Lindholm et al, 1973;Rudwan, 1977).…”

Section: Discussionmentioning

confidence: 99%