A rare case of a secondary pituitary abscess arising in a craniopharyngioma with atypical presentation and clinical course
| Autor: | Sergio Obeso Aguera, Fernando Toral, Jaime Viera Artiles, Carlos Bucheli Peñafiel, David Mato Mañas, Geanella Yange Zambrano, Patricia Lopez Gomez, Eloy Manuel Rodríguez Rodríguez, Enrique Marco de Lucas, Rubén Martín Láez |
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| Rok vydání: | 2022 |
| Předmět: |
Transsphenoidal surgery
medicine.medical_specialty medicine.diagnostic_test business.industry Hypophysitis medicine.medical_treatment Pituitary Abscess Hypopituitarism medicine.disease Craniopharyngioma Lesion 03 medical and health sciences 0302 clinical medicine Biopsy medicine Surgery Neurology (clinical) Radiology medicine.symptom business Abscess 030217 neurology & neurosurgery |
| Zdroj: | Neurocirugía. 33:99-104 |
| ISSN: | 1130-1473 |
| DOI: | 10.1016/j.neucir.2020.11.008 |
| Popis: | Pituitary abscesses are very uncommon. They are divided into primary, arising within a healthy gland, and secondary, observed with an underlying pre-existing lesion. Here we present the eighth case reported of a secondary abscess within a craniopharyngioma. A 59-year-old-woman presented with a 3-week history of headache, and fever. Physical examination was unremarkable. An Magnetic Resonance Imaging (MRI) showed a pituitary lesion suggestive of a chronic inflammatory process. She was diagnosed with lymphocytic meningitis with hypophysitis and she was treated with corticosteroids. Two months later she presented with headache and fever again. Control MRI showed enlargement of the pituitary lesion. Therefore, a transsphenoidal biopsy was performed. During the procedure, purulent material was released. Histological study demonstrated a craniopharyngioma and meningeal inflammation. Empiric antibiotics were started. Three months post-operatively, a follow-up MRI showed a suspect minimal residual mass. Secondary pituitary abscesses are rare. The key to successful management is a high index of suspicion. Transsphenoidal surgical evacuation plus antibiotics is the mainstay of treatment. Although most symptoms resolve, endocrinopathies improve only rarely. |
| Databáze: | OpenAIRE |
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