2001 Volume 10 Issue 7 Pages 454-460
We had 6 cases pituitary abscess since 1980 and analyzed the clinical feature of this rare entity in this study. Between 1980 and 2000, we had 465 cases with parasellar tumors. All the cases were treated surgically and diagnosis was made by histopathology. There were 6 cases of pituitary abscess. Two were male and 4 were female with an average age at 36.3-year-old. Chief complaints were bilateral hemianopsia in 5 cases and headache and high fever in one. Endocrinological dysfunction of pituitary was found in 3 cases. The duration from the onset of symptom to preoperative diagnosis ranged from 20 days to 8 months with an average of 4.4 months. The cause of abscess was meningitis in 2 cases, postoperative infection with pituitary adenoma in 1 case, sphenoid sinutitis in 1 case and unknown in the remaining 2 cases. For the surgical treatment, transsphenoidal approach was chosen in 3 cases and transcranial approach in 3 cases. The confirmation of microorganism was obtained only in 1 case and the other 5 cases resulted in negative. The neurological deficit was all recovery postoperatively, but the endocrinopathy demonstrated no recovery. The follow-up period ranged from 1 year to 16 years with an average of 11.1 years. The recurrence was not observed in any case. The mortality with pituitary abscess was high in the past decades but recent advancement of the treatment of infection enabled us to obtain no mortality as demonstrated in the present study. Hoevever, the endocrinopathy due to inflammation on pituitary gland was irreversible, despite of that the neurological deficits caused by mass were well recovered. To improve the functional outcome with pituitary abscess, careful preoperative diagnosis and early surgical treatment are recommended.
