Secondary Pituitary Abscess Inside Adenoma: A Case Report and Review of Literature

Abstract

Background: Pituitary abscesses within pre-existing pituitary conditions, such as craniopharyngioma, pituitary adenoma, or Rathke cleft cyst, are quite rare. A case of pituitary abscess secondary to adenoma is presented, and the literature is reviewed.

Case description: An 11-year-old boy presented with a 3-day history of sudden-onset headache and visual loss. Magnetic resonance imaging demonstrated a sellar region lesion with intralesional hemorrhage. Preoperative diagnosis was pituitary adenoma with apoplexy. An endoscopic transnasal transsphenoidal approach was used for emergent total tumor resection. Pathology confirmed the diagnosis of pituitary adenoma with apoplexy and inflammation, and microbiologic examination was positive for Staphylococcus aureus.

Conclusions: Secondary pituitary abscess is a rare entity, and preoperative diagnosis is challenging. The treatment strategy includes prompt surgical resection and drainage of the abscess, followed by prolonged antibiotic therapy.

Keywords: Endoscope; Pituitary abscess; Pituitary adenoma; Transsphenoidal.