Michael M Safaee1, Lewis Blevins2, Christopher S Liverman3, Philip V Theodosopoulos2. 1. Department of Neurological Surgery, University of California, San Francisco, California, USA. Electronic address: michael.safaee@ucsf.edu. 2. Department of Neurological Surgery, University of California, San Francisco, California, USA. 3. Department of Pathology, University of California, San Francisco, California, USA.
Abstract
BACKGROUND: Pituitary abscesses are rare clinical entities that can occur in the setting of a normal gland or underlying disease, including adenoma, craniopharyngioma, or Rathke cleft cyst. Although once believed to be indolent, when these secondary abscesses occur in the setting of an adenoma, they can be associated with significant clinical morbidity. Most patients present with visual disturbances or headache without fever or meningitis. CASE DESCRIPTION: We present the case of a 63-year-old woman with remote history of Staphylococcus osteomyelitis who presented with 1 week of diplopia, partial left third nerve palsy, and bitemporal hemianopsia who was found to have a pituitary abscess in the setting of an adenoma. She underwent drainage of the abscess and resection of her adenoma followed by complete resolution of her symptoms. CONCLUSIONS: This case highlights the need for prompt treatment of pituitary abscesses, with the possibility of excellent neurologic recovery.
BACKGROUND: Pituitary abscesses are rare clinical entities that can occur in the setting of a normal gland or underlying disease, including adenoma, craniopharyngioma, or Rathke cleft cyst. Although once believed to be indolent, when these secondary abscesses occur in the setting of an adenoma, they can be associated with significant clinical morbidity. Most patients present with visual disturbances or headache without fever or meningitis. CASE DESCRIPTION: We present the case of a 63-year-old woman with remote history of Staphylococcus osteomyelitis who presented with 1 week of diplopia, partial left third nerve palsy, and bitemporal hemianopsia who was found to have a pituitary abscess in the setting of an adenoma. She underwent drainage of the abscess and resection of her adenoma followed by complete resolution of her symptoms. CONCLUSIONS: This case highlights the need for prompt treatment of pituitary abscesses, with the possibility of excellent neurologic recovery.