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Kim, Park, Park, and Baek: Primary Pituitary Abscess: An Unusual Case of Diabetes Insipidus
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2006; 21(5): 408-413.

Published online: 20 October 2006

DOI: https://doi.org/10.3803/jkes.2006.21.5.408

Primary Pituitary Abscess: An Unusual Case of Diabetes Insipidus

Ji Hye Kim, Ji-Hyun Park1, Tae-Sun Park1, Hong-Sun Baek1

Department of Internal Medicine, Presbyterian Medical Center, Korea.

1Department of Internal Medicine, Division of Endocrinology and Metabolism, Chonbuk National University Medical School, Korea.

Received 15 February 2006       Accepted 21 June 2006

Copyright © 2006 Korean Endocrine Society

Abstract

A 58-year-old man was investigated for his complaints of chronic frontal headache. The endocrinologic hormone studies were compatible with diabetes insipidus and suggestive of panhypopituitarism. Sellar MRI showed a cystic sellar lesion with peripheral rim enhancement after contrast injection, and this led to an initial diagnosis of pituitary adenoma with hemorrhagic necrosis. He underwent an operation via the transsphenoidal approach to access the pituitary gland. During the operation, purulent materials were obtained and no tumor or other associated lesions were detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. All the cultures we obtained were negative. He was put on antibiotics and discharged after 4 weeks. Now, 18 months after treatment, he is doing well.

Keywords: Abscess, Panhypopituitarism, Pituitary gland

Figures and Tables

Fig. 1
Preoperative sagittal (A) and coronal (B) T1-weighted gadolinium-enhanced MR images show a cystic sellar mass associated with thickened stalk, demonstrating peripheral rim enhancing lesion following gadolinium injection. Sagittal T1-weighted MR image(C) after transsphenoidal drainage shows are a partially empty sella without residual lesion and the pituitary stalk is in the midline.
jkes-21-408-g001
Fig. 2
Microscopic finding shows necrotic pituitary tissue with evidence of inflammation, including polymorphonuclear leukocytes. There are no tumor components (PAP, ×200).
jkes-21-408-g002
Table 1
Water deprivation test
jkes-21-408-i001

*Pitressin 5 unit subcutaneous injection.

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