Primary pituitary gland abscess in a 13-year-old girl. A clinical case description

2021 ◽  
pp. 289-302
Author(s):  
Aleksey Nikolaevich Shkarubo ◽  
Zokirzhon Utkurovich Zokhidov ◽  
Matvey Igorevich Livshits ◽  
Aleksandr Vyacheslavovich Levov ◽  
Egor Gennadievich Chmutin ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Clinical Case ◽  
Pediatric Population ◽  
Sella Turcica ◽  
Acute Inflammatory Response ◽  
Atypical Presentation ◽  
Pituitary Abscess ◽  
Magnetic Resonance Studies ◽  
Radiological Features ◽  
Specific Symptoms

A primary abscess in the region of the Sella turcica is a rare neurosurgical pathology especially in the pediatric population. This pathology has no specific symptoms and may have an atypical presentation. It has no specific radiological features making diagnosis very difficult. In this article, we report on a 13-year-old girl with a confirmed primary pituitary abscess. Clinical and instrumental investigations as well as hormonal profile indicated a lesion of the Rathkes pouch- like a craniopharyngioma and to a lesser extent, a pituitary adenoma. In this case, laboratory and Magnetic resonance studies did not show any features of systemic or local acute inflammatory response respectively. The child underwent a surgery, during which the diagnosis was made — primary abscess of the pituitary gland.

Pituitary abscesses

1977 ◽  
Vol 46 (5) ◽  
pp. 601-608 ◽  
Author(s):  
James N. Domingue ◽  
Charles B. Wilson
Keyword(s):  
Bacterial Meningitis ◽  
Preoperative Diagnosis ◽  
World Literature ◽  
Sella Turcica ◽  
Visual Field Defects ◽  
Pituitary Abscess ◽  
Presumptive Diagnosis ◽  
Content Type ◽  
Purulent Meningitis ◽  
Fine Print

✓ Seven cases of pituitary abscess are presented and the relevant world literature is reviewed. An enlarged sella co-existing with bacterial meningitis, or bacterial meningitis coinciding with a known or suspected pituitary tumor should suggest the diagnosis of pituitary abscess. Visual field defects should evoke similar suspicion when present in a patient with meningitis. This reasoning enabled us to make the first reported preoperative diagnosis of pituitary abscess. Therefore, in the management of purulent meningitis, we recommend the following: first, skull films are mandatory; second, if the sella turcica is abnormal, the correct presumptive diagnosis is pituitary abscess; and third, if prompt improvement does not follow appropriate antibiotic therapy, the suspected abscess should be explored and drained via the transsphenoidal approach.

scholarly journals Drainage or Packing of the Sella? Transsphenoidal Surgery for Primary Pituitary Abscess: Report of Two Cases

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Soichi Oya ◽  
Junichiro Kumai ◽  
Taku Shigeno
Keyword(s):  
Cerebrospinal Fluid ◽  
Transsphenoidal Surgery ◽  
Sella Turcica ◽  
Cerebrospinal Fluid Leak ◽  
Anterior Wall ◽  
Rare Clinical Entity ◽  
Pituitary Abscess ◽  
Abscess Drainage ◽  
Postoperative Course ◽  
Fluid Leak

The detailed surgical procedure of the transsphenoidal surgery for pituitary abscess has scarcely been described previously because it is a very rare clinical entity. The authors reported two cases of primary pituitary abscess. In case 1, the anterior wall of the sella turcica was reconstructed with the vomer bone after irrigating the abscess cavity, but the sella was not packed by fat for fear of the persistent infection by devascularized tissues. This led to the postoperative meningocele, the cerebrospinal fluid leak, and bacterial meningitis despite the successful abscess drainage. In case 2, tight sellar packing and reconstruction of the sellar wall were performed to avoid these postoperative complications, which resulted in complete drainage and uneventful postoperative course. Although accumulation of more cases is obviously needed to establish the definitive surgical technique in pituitary abscess surgery, our experience might suggest that packing of the sella is not impeditive for postoperative sufficient drainage.

scholarly journals Metastases to the pituitary gland

2004 ◽  
Vol 16 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Daniel R. Fassett ◽  
William T. Couldwell
Keyword(s):  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Skull Base ◽  
Survival Rates ◽  
Tumor Resection ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Visual Field Defects ◽  
Malignant Neoplasms ◽  
Pituitary Metastases

Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland; however, in certain cases of malignant neoplasms pituitary metastases do occur. Breast and lung cancers are the most common diseases that metastasize to the pituitary. Breast cancer metastasizes to the pituitary especially frequently, with reported rates ranging between 6 and 8% of cases. Most pituitary metastases are asymptomatic, with only 7% reported to be symptomatic. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia are the most commonly reported symptoms. Diabetes insipidus is especially common in this population, occurring in between 29 and 71% of patients who experience symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Overall, neurohypophysial involvement seems to be most prevalent, but breast metastases appear to have an affinity for the adenohypophysis. Differentiating metastasis to the pituitary gland from bone metastasis to the skull base, which invades the sella turcica, can also be difficult. In metastasis to the pituitary gland, surrounding sclerosis in the sella turcica is usually minimal compared with metastasis to the skull base. Treatment for these tumors is often multimodal and includes surgery, radiation therapy, and chemotherapy. Tumor invasiveness can make resection difficult. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved. Survival among these patients is poor with mean survival rates reported to range between 6 and 22 months.

The Endocrine System: Pituitary Gland

2017 ◽  
Author(s):  
Omer Doron ◽  
Jose E Cohen ◽  
Iddo Paldor
Keyword(s):  
Pituitary Gland ◽  
Human Body ◽  
Sella Turcica ◽  
Endocrine System ◽  
Portal System ◽  
Balance Growth ◽  
Sexual Drive ◽  
Pituitary Dysfunction ◽  
Physiologic Function ◽  
And Function

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function. This review contains 3 figures, and 38 references, Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica

The Nasal Gateway for Pituitary Surgery

1988 ◽  
Vol 2 (4) ◽  
pp. 193-200 ◽  
Author(s):  
Mary D. Lekas
Keyword(s):  
Pituitary Gland ◽  
Sella Turcica ◽  
Pituitary Tumors ◽  
Pituitary Surgery ◽  
Transsphenoidal Approach ◽  
External Rhinoplasty

There has been an evolution in the transseptal transsphenoidal approach for pituitary surgery. The nasal approach to the pituitary gland can be from the sublabial transseptal transsphenoidal; the transseptal transsphenoidal; the alotomy transseptal transsphenoidal; the external rhinoplasty transsphenoidal; the transnasal by mobilizing the whole nose on a pedicle; the transseptal infranasal; the midline columellar incision; all types of nasofacial incisions; and transethmoidal approach with nasal instrumentation. The transsphenoidal hypophysectomy surgery has become a safe and effective approach for pituitary tumors. We are mainly concerned with the transnasal and not the transethmoidal approach to the sella turcica at this time.

scholarly journals An Atypical Presentation of Chylous Ascites

2015 ◽  
Vol 1 (1) ◽  
pp. 17-20
Author(s):  
TR Tanusha ◽  
Mamatha B Patil
Keyword(s):  
Developing Countries ◽  
Infectious Diseases ◽  
Peritoneal Cavity ◽  
Pediatric Population ◽  
Chylous Ascites ◽  
Developed Countries ◽  
Atypical Presentation ◽  
Common Causes

ABSTRACT Chylous ascites (CA) is the extravasation of milky chyle into the peritoneal cavity. Chylous ascites commonly affects adults in 50 to 60 years of age but can also occur in pediatric population. In adults, the most common causes are abdominal malignancies and cirrhosis which account for more than two-third of the cases in developed countries, whereas infectious diseases, such as tuberculosis and filariasis, are prevalent in developing countries. Other causes include congenital, inflammatory, postoperative, traumatic and miscellaneous disorders. We hereby report two atypical cases of chylous ascites and also briefly discuss the causes and treatment. How to cite this article Tanusha TR, Patil MB. An Atypical Presentation of Chylous Ascites. J Med Sci 2015;1(1):17-20.

scholarly journals Morphometric analysis of the sella turcica in Northeastern Brazil

2021 ◽  
Author(s):  
Pablo Mariz de Oliveira ◽  
Amanda do Nascimento Oliveira e Carneiro ◽  
Fábio Antônio Serra de Lima Júnior ◽  
Daniel Dantas da Silva ◽  
Leticia Leite Cavalcante ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Linear Correlation ◽  
Sella Turcica ◽  
Northeastern Brazil ◽  
Surgical Approaches ◽  
Linear Measurements ◽  
Positive Linear Correlation ◽  
Skull Measurements ◽  
And Gender ◽  
Human Skulls

Introduction: The sella turcica is a structure of the median region of the sphenoid bone. Variations in its morphology are relevant as it is a region subjected to several surgical procedures, mainly related to the pituitary gland. Objective: To analyze the morphology of the sella turcica and its sexual dimorphism in Northeastern Brazil. Methods: Fifteen human skulls from the Federal University of Paraíba (UFPB) were used. The qualitative analysis was performed by classifying the shape of the sella turcica into three types: U, J and flattened. Morphometric data was collected and statistically analyzed to evaluate the relationship between sella morphometry and gender, and between sella and skull measurements. Values of p< 0.05) in the sella turcica length (STL) and skull length (SL), with male skulls being larger in both cases. The other linear measurements didn’t show differences between the sexes (p>0.05). There was a positive linear correlation between STL and SL, and a negative linear correlation between sella turcica width (STW) and sella turcica height (STH) and between STH and bitemporal width (BTW). Conclusion: The results point to important differences in the morphometric parameters evaluated with original findings for this population. Knowledge of the morphology of the sella is essential to plan safer surgical approaches in the pituitary gland or related anatomical structures.

scholarly journals 32 Clinical case of hypohydrotic ectoderm dysplasia: specific symptoms from the ENT organs

2021 ◽  
Author(s):  
S Gubanova ◽  
I Zelenkova ◽  
L Namazova-Baranova ◽  
A Alekseeva ◽  
L Aslamazyan
Keyword(s):  
Clinical Case ◽  
Specific Symptoms

Pituitary gland and sella turcica in human trisomy 21 fetuses related to axial skeletal development

1998 ◽  
Vol 80 (5) ◽  
pp. 494-500 ◽  
Author(s):  
Inger Kj�r ◽  
Jean W. Keeling ◽  
Ingermarie Reintoft ◽  
Dorrit Nolting ◽  
Birgit Fischer Hansen
Keyword(s):  
Pituitary Gland ◽  
Trisomy 21 ◽  
Skeletal Development ◽  
Sella Turcica

The Endocrine System: Pituitary Gland

2017 ◽  
Author(s):  
Omer Doron ◽  
Jose E Cohen ◽  
Iddo Paldor
Keyword(s):  
Pituitary Gland ◽  
Human Body ◽  
Sella Turcica ◽  
Endocrine System ◽  
Portal System ◽  
Balance Growth ◽  
Sexual Drive ◽  
Pituitary Dysfunction ◽  
Physiologic Function ◽  
And Function

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function. This review contains 3 figures, and 38 references, Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica

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