Pituitary abscess occurring 12 years after transsphenoidal surgery for Rathke's cleft cyst.

Autor:	Ishii H; Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan., Ito S; Department of Otolaryngology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan., Teramoto S; Department of Neurosurgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan., Sugiyama N; Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan., Ueno H; Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan., Tsutsumi S; Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan.
Jazyk:	angličtina
Zdroj:	Radiology case reports [Radiol Case Rep] 2024 Aug 17; Vol. 19 (11), pp. 4974-4977. Date of Electronic Publication: 2024 Aug 17 (Print Publication: 2024).
DOI:	10.1016/j.radcr.2024.07.155
Abstrakt:	A 73-year-old man who previously underwent transsphenoidal surgery for a Rathke's cleft cyst presented with headache and fever. Ophthalmological examination revealed the progression of visual impairment. Cerebral magnetic resonance imaging revealed a cystic mass in the sellar and suprasellar regions with rim-like enhancement. An intralesional hyperintense area with temporal enlargement was identified using serial diffusion-weighted imaging. Lumbar cerebrospinal fluid tap findings indicated bacterial meningitis. The patient had undergone a transsphenoidal surgery; an intraoperatively implanted sheet of artificial dura mater from the previous surgery was identified adjacent to the sellar floor. After incising the floor, the pus material was drained and methicillin-sensitive Staphylococcus aureus was identified on culture. Consecutive antibiotic treatment resolved the pituitary abscess (PA). PA may develop as a late complication of transsphenoidal surgery, particularly when an artificial material is implanted during surgery. Clinical signs coupled with temporal findings on diffusion-weighted sequences can facilitate the diagnosis and activity of PA and serve as a guide for proper management. (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze:	MEDLINE
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