Ostalo

https://doi.org/10.20471/acc.2016.55.04.17

Pituitary abscess with unusual clinical course

Milica Medić Stojanoska ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, Novi Sad, Serbia
Duško Kozić ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Oncology Institute of Vojvodina, Diagnostic Imaging Center, Sremska Kamenica, Serbia
Mladen Bjelan ; Oncology Institute of Vojvodina, Diagnostic Imaging Center, Sremska Kamenica, Serbia
Petar Vuleković ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinical Department of Neurosurgery, Novi Sad, Serbia
Nada Vučković ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinical Department of Pathology and Histology, Novi Sad, Serbia
Bojan Vuković ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Emergency Center, Novi Sad, Serbia
Branka Kovačev Zavišić ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, Novi Sad, Serbia

Sažetak

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, compatible with chronic inflammation. To the best of our knowledge, there are no studies in the literature describing such a
pattern of chronic evolution of pyogenic pituitary abscess with consequent chronic inflammatory changes with granulation tissue proliferation, mimicking macroadenoma.

Ključne riječi

Pituitary gland, anterior; Abscess; Pituitary neoplasms; Magnetic resonance imaging; Pituitary hormone deficiency

Hrčak ID:

178117

URI

https://hrcak.srce.hr/178117

Datum izdavanja:

15.12.2016.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.292 *