Pituitary abscess with unusual clinical course.
PITUITARY ABSCESS WITH UNUSUAL CLINICAL COURSE.
Acta Clin Croat. 2016 12;55(4):650-4
Authors: Stojanoska MM, Kozić D, Bjelan M, Vuleković P, Vučković N, Vuković B, Zavišić BK
Abstract
The aim is to present unusual clinical course and magnetic resonance imaging
(MRI) features of pituitary abscess. A 59-year-old man presented with fever, polyuria, polydipsia and
marked weight loss within the last two months. Basic endocrinology tests revealed the presence of
anterior pituitary dysfunction, associated with central diabetes insipidus and increased levels of inflammatory
markers. The presence of expansile sellar lesion, showing restricted diffusion signal pattern
compatible with acute pituitary pyogenic abscess was found on MRI. Regression of pituitary abscess
was obvious during the next few weeks of parenteral antibiotic treatment. Adequate substitution treatment
with L thyroxine, hydrocortisone, testosterone and desmopressin was achieved. Seventeen
months later, clinical deterioration associated with recurrent pituitary abscess was confirmed on MRI.
Abscess regression was obvious again after conservative treatment. However, control MRI study performed
three years after initial scanning revealed the presence of pituitary tumor, most consistent with
macroadenoma. Surgical intervention was ordered. Histologic evaluation indicated the presence of
fibrotic changes, associated with granulation tissue and rare cellular elements, compati...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
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