Turkish Neurosurgery 2013 , Vol 23 , Num 5
Diagnosis and Management of Pituitary Abscess: A Case Series and Review of the Literature
Murat ALTAS1, Alpay SEREFHAN2, Gokalp SILAV4, Ajlan CERCI3, Kerim Kenan COSKUN3, Ilhan ELMACI4
1Mustafa Kemal University, Faculty of Medicine, Department of Neurosurgery, Antakya, Turkey
2Diyarbakr Government Hospital, Department of Neurosurgery, Diyarbakir, Turkey
3Goztepe Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey
4Acibadem University, Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.7443-12.2 AIM: Pituitary abscess is a disorder characterized with central nervous system (CNS) infection, mass effect, and endocrine dysfunction. These abscesses generally occur due to hematogenous spread in conditions such as paranasal sinusitis, sepsis, and where the blood brain barrier breaks down. This paper aims to discuss four cases of preoperatively diagnosed pituitary abscess in the light of the literature.

MATERIAL and METHODS: Following detailed clinical and hormonal examinations and imaging tests, 210 cases of pituitary adenoma and other sellar pathologies were operated on at the Neurosurgery clinic of Gztepe Training and Research Hospital.

RESULTS: All the patients showed fever, systemic signs of toxemia and endocrine dysfunction at the time of diagnosis. In these cases, a preoperative diagnosis of the disease was made thanks to characteristic MRI findings. The four cases were operated by the transnasal transsphenoidal approach and histopathological and microbiological studies were performed for surgical specimens.

CONCLUSION: Pituitary abscesses are rare disorders responsible for a high mortality risk. Mortality and morbidity can be reduced by early surgical drainage and appropriate antibiotic treatments. Additionally, these cases should be closely followed-up in terms of pituitary insufficiency, surgical complications and infection. Keywords : Pituitary abscess, MRI imaging, Transsphenoidal surgery, Anti-microbial therapy

Corresponding author : Murat Altas, draltasmurat@yahoo.com