Pituitary abscess: a descriptive analysis of a series of 19 patients—a multi-center experience

作者：Qiang Xue, Xiuhua Shi, Xiaoling Fu, Yating Yin, Hui Zhou, Suiyi Liu, Qingfang Sun, Jin Meng, Liuguan Bian, Tan Hong, Hua He · 发表于：European journal of medical research · 年份：2024 · DOI：10.1186/s40001-024-01749-z · 被引用次数：4 · 研究领域：Pituitary Gland Disorders and Treatments、Peripheral Neuropathies and Disorders、Cerebral Venous Sinus Thrombosis

OBJECTIVES: Pituitary abscess (PA) accounts for only 0.3-0.5% of sellar masses, and the lack of specific clinical symptoms makes diagnosing PA difficult without a surgical biopsy. In clinical practice, PA is often mistaken for cystic pituitary adenoma, craniopharyngioma, and Rathke's cyst. Thus, this study aims to investigate challenges in diagnosing PA and evaluate the importance of combining intraoperative surgery with postoperative antibiotic treatment. METHODS: We conducted a retrospective analysis of 19 patients diagnosed with PA through histopathology. All patients underwent transsphenoidal surgery (TSS) for pituitary adenomas after undergoing comprehensive preoperative evaluations, including routine tests, endocrine assay, and imaging examination. Furthermore, we compared different treatments for pituitary abscess (PA) to determine the most effective approach for achieving a favorable prognosis. RESULTS: The most prevalent symptom of PA was headache, especially in the frontal-temporal and vertex regions, ranging from mild to moderate severity. Hypopituitarism-related symptoms were also frequently observed, including hypaphrodisia, cold sensitivity, fatigue, weight loss, polyuria, and amenorrhea. Twelve patients exhibited abnormalities in endocrinology examinations. Diagnosing PA correctly is challenging. In our study, none of the patients were correctly diagnosed with PA prior to surgery, and many sellar lesions were misdiagnosed. The favorable prognosis was largely at...