Clinical features and treatment of pituitary abscess

WU Weidong; LIU Ying; LIANG Yong

Abstract：Objective To investigate the clinical features and treatment of pituitary abscess.Methods Clinical data of 10 patients with pituitary abscess from January 2019 to March 2022 in our hospital were retrospectively analyzed,We summarize the clinical features,hormonal change,MR image features,and treatment of patients with pituitary abscesses.Results There were 10 patients with pituitary abscess,including 2 male patients and 8 female patients,with an average age of 44.6±15.0 years old,8 patients had headache onset,7 patients had vision defect,and 4 patients had diabetes insipidus.There were 3 cases of hypothyroidism,5 cases of adrenal insufficiency,and 7 cases of hypogonadism.Typical MR image features were hypointense signal on T1WI in 7 cases,hyperintensity on T2WI in 6 cases,and peripheral ring enhancement in 8 cases.Only 1 case of bacterial culture was positive,and 1 case had a recurrence.Conclusion Headache,hypopituitarism and visual defect are the most common symptoms of pituitary abscess.Typical MR image are hypointense on T1WI and hyperintensity on T2WI,and peripheral ring enhancement.The positive rate of culture is low,and a sample of the abscess wall is sent for culture might increase the chance of pathogen isolation.The treatment of pituitary abscess by transsphenoidal approach has a lower recurrence rate and usually patient have an good outcome.