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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2024; 85(02): e53-e58
DOI: 10.1055/a-2297-3909
Case Report

Primary Pituitary Abscess: Two Case Reports

Sayak R. Ghosh
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Isabella L. Pecorari 
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Abigail Funari 
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Alexander J. Ledet
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Anne Lally
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Alireza Karandish
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
,
Vijay Agarwal
1   Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, New York, United States
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Abstract

Introduction Pituitary abscess is a rare disorder that represents a small fraction of all pituitary lesions. In this report, we present two additional cases with unique features to promote awareness and prompt surgical intervention.

Case Presentations A 42-year-old male presented with headache, photophobia, subjective fever, dizziness, imbalance, nausea, and vomiting. A pituitary hormone panel confirmed hypothyroidism and suggested central hypogonadism and secondary adrenal insufficiency. Magnetic resonance imaging (MRI) showed a large sellar mass measuring 2.5 cm × 1.8 cm × 1.6 cm (CC × XT × AP). A 76-year-old woman presented with several months of headaches and unsteady gait in the setting of a known previously asymptomatic sellar lesion, measuring 1.8 cm × 1.2 cm × 1.5 cm (XT × CC × AP). Repeat MRI demonstrated possible hemorrhage within the lesion. In both cases, a preliminary diagnosis of pituitary macroadenoma was made, but transsphenoidal surgery revealed an encapsulated abscess; cultures obtained from the abscesses stained for gram-positive bacteria.

Conclusion Pituitary abscess is a rare, potentially life-threatening disorder that may be easily mistaken for other sellar lesions. In this review, we contribute two additional cases of pituitary abscesses to increase awareness and emphasize the importance of proper diagnosis and management.

Keywords

pituitary abscess - sellar lesions - hypopituitarism - case reports


Publication History

Received: 28 September 2022

Accepted: 21 October 2023

Accepted Manuscript online:
01 April 2024

Article published online:
25 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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