Pituitary abscess:a review of 7 cases and some points about its diagnosis / 中国实用内科杂志

ABSTRACT

Objective To analyze the clinical features,auxiliary examination,diagnosis and treatment of pituitary abscess.Methods A retrospective analysis was done in 7 cases of pituitary abscess.All cases’ final diagnose were confirmed by histopathological results.Results 1.Four cases were diagnosed as primary pituitary abscess,the others 3 cases as secondary pituitary abscess which was associated with pituitary adenoma,pituitary cyst,craniopharyngeal duct tumor respectively.2.Clinical featuresOf 7 cases,fever was determined in 6 cases,visual disturbance or temporal hemianopia in 5 cases,headache associated with anorexia and nausea and vomitting in 4 cases.High white blood cell counts was present in 3 cases,high PRL levels in 4 cases.Three cases were associated with hypothyroidism,2 cases with hypoadrenocorticism.MR image showed isointense or hypointense signal on T1WI and isointense or hyperintense signal on T2WI in pituitary abscess.Postcontrast T1WI showed a ring-shaped enhancement.Two cases were diagnosed by MR images and clinical features before surgery,the others by surgical histopathology.3.TreatmentAll cases were treated with surgery,followed by antibiotics therapy.After operation all symptoms were improved except for optic nerve function.Conclusion It is suggestive of pituitary abscess when any patient present firstly with fever,headache,visual or eyeshot disturbance,partial or whole hypopituitarism associated with saddle area mass.Earlier diagnosis,timely surgery and postoperative proper antibiotics therapy are the keys to the treatment of pituitary abscess.