Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience

A pituitary abscess (PA) is a rare intracranial lesion. It is a critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. It occurs either as a primary disease or because of an infection and is associated with poor prognosis. In this article, we...

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Main Authors: Ramalingam Giridharan, Nirmal Kumar, J. Srisaravanan
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2025-08-01
Series:Indian Journal of Neurosurgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1778130
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author Ramalingam Giridharan
Nirmal Kumar
J. Srisaravanan
author_facet Ramalingam Giridharan
Nirmal Kumar
J. Srisaravanan
author_sort Ramalingam Giridharan
collection DOAJ
description A pituitary abscess (PA) is a rare intracranial lesion. It is a critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. It occurs either as a primary disease or because of an infection and is associated with poor prognosis. In this article, we share our experience with PA. At our institution, we operated on five cases of pituitary abscess since 2016. All the cases presented with bitemporal hemianopia and headache. None of them had fever. Pituitary hormones were normal except in two patients with a previous history of hypothyroidism. Magnetic resonance imaging (MRI) of the brain showed pituitary macroadenoma. They underwent the endoscopic transnasal transsphenoidal approach. Postoperatively their vision has improved. Endocrine functions were normal in all the patients following surgery. Culture sensitivity was sterile in all the patients. Diagnosis of pituitary abscess is highly difficult before surgery. Hence, the diagnosis should be considered when a patient presents with fever, headache, and signs of pituitary dysfunction and meningeal inflammation. Surgical and medical management leads to a lower mortality rate and a higher probability of hormone function recovery.
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spelling doaj-art-c0372658dd9f4feebad9db59e6b49c7c2025-08-20T03:59:36ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672025-08-01140218719010.1055/s-0043-1778130Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional ExperienceRamalingam Giridharan0https://orcid.org/0009-0004-6642-6749Nirmal Kumar1J. Srisaravanan2Department of Neurosurgery, Madurai medical College and Hospital, Madurai, Tamil Nadu, IndiaDepartment of Neurosurgery, Madurai medical College and Hospital, Madurai, Tamil Nadu, IndiaDepartment of Neurosurgery, Madurai medical College and Hospital, Madurai, Tamil Nadu, IndiaA pituitary abscess (PA) is a rare intracranial lesion. It is a critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. It occurs either as a primary disease or because of an infection and is associated with poor prognosis. In this article, we share our experience with PA. At our institution, we operated on five cases of pituitary abscess since 2016. All the cases presented with bitemporal hemianopia and headache. None of them had fever. Pituitary hormones were normal except in two patients with a previous history of hypothyroidism. Magnetic resonance imaging (MRI) of the brain showed pituitary macroadenoma. They underwent the endoscopic transnasal transsphenoidal approach. Postoperatively their vision has improved. Endocrine functions were normal in all the patients following surgery. Culture sensitivity was sterile in all the patients. Diagnosis of pituitary abscess is highly difficult before surgery. Hence, the diagnosis should be considered when a patient presents with fever, headache, and signs of pituitary dysfunction and meningeal inflammation. Surgical and medical management leads to a lower mortality rate and a higher probability of hormone function recovery.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1778130pituitary abscessendoscopic trans nasal trans sphenoidal approach
spellingShingle Ramalingam Giridharan
Nirmal Kumar
J. Srisaravanan
Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience
Indian Journal of Neurosurgery
pituitary abscess
endoscopic trans nasal trans sphenoidal approach
title Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience
title_full Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience
title_fullStr Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience
title_full_unstemmed Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience
title_short Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience
title_sort unusual presentations of sellar and suprasellar space occupying lesion our institutional experience
topic pituitary abscess
endoscopic trans nasal trans sphenoidal approach
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1778130
work_keys_str_mv AT ramalingamgiridharan unusualpresentationsofsellarandsuprasellarspaceoccupyinglesionourinstitutionalexperience
AT nirmalkumar unusualpresentationsofsellarandsuprasellarspaceoccupyinglesionourinstitutionalexperience
AT jsrisaravanan unusualpresentationsofsellarandsuprasellarspaceoccupyinglesionourinstitutionalexperience