A Case of Pituitary Abscess

ABSTRACT

A 35-year-old woman presented with amenorrhea, polydipsia, polyuria, general weakness and intolerance of cold; the duration of these symptoms had been five years. On brain MRI with Gadolinium enhancement, an intrasellar mass protruding above the sella turcica was demonstrated, and the patient was thought to be a pituitary adenoma. The transsphenoid approach(TSA) was employed, and during at surgery, pus was drained. In a culture of this, no microorganism was identified, and on histologic examination, which suggested lymphocytic infiltration with fibrosis and occasional neutrophils were seen, findings which suggested the possibility of capsule of chronic abscess. Transient postoperative polyuria was noted, but this disappreared soon after broad spectrum antibiotics were administered; hormonal therapy was required for anterior and posterior pituitary hypofunction. Clinical features of this condition and its treatment are also discussed, and the literature pertaining to reported cases is reviewed. An enlarged or erosive sella coexisting with bacterial meningitis, sphenoid sinusitis, cavernous sinus thrombophlebitis or bacterial meningitis coincident with a known or suspected pituitary tumor suggests the presence of a pituitary abscess.