A rare case of a secondary pituitary abscess arising in a craniopharyngioma with atypical presentation and clinical course

xlomafota13 shared this article with you from Inoreader A rare case of a secondary pituitary abscess arising in a craniopharyngioma with atypical presentation and clinical course Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Feb 10:S1130-1473(21)00005-1. doi: 10.1016/j.neucir.2020.11.008. Online ahead of print. ABSTRACT 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 dem onstrated 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. PMID:33581993 | DOI:10.1016/j.neucir.2020.11.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.