Kim Hyo-Chang, Kang Seok-Gu, Huh Pil-Woo, Yoo Do Sung, Cho Kyoung Suok, Kim Dal Soo
Department of Neurosurgery, The Catholic University of Korea College of Medicine, Uijeongbu St. Mary's Hospital, 65-1 Kumohdong, Uijeongbu, Gyeonggi 480-130, Republic of Korea.
J Clin Neurosci. 2007 Nov;14(11):1135-9. doi: 10.1016/j.jocn.2006.03.012. Epub 2007 Apr 8.
Pituitary abscess is a rare and potentially lethal condition. Pituitary abscess in a pregnant woman has not been previously described. A 38-year-old pregnant woman (34 weeks gestation) with a pituitary mass complained of a progressive headache and sudden visual impairment. She was afebrile and had no inflammatory symptoms on admission. On MRI, the preoperative diagnosis was pituitary adenoma with sphenoid sinusitis. She underwent an uncomplicated transsphenoidal procedure for removal of the pituitary mass. The next day, labor commenced and a healthy preterm baby was delivered. Pathologic examination of the intrasellar mass showed polymorphonuclear cells, debris and no tumor cells. The sellar contents were cultured and Streptococcus viridans was grown. To our knowledge this is the first case of pituitary abscess reported during pregnancy. Although the patient was pregnant, the transsphenoidal approach was safe for the mother and the fetus. Surgical drainage and antibiotic therapy are required for the definitive treatment of this condition.
垂体脓肿是一种罕见且可能致命的疾病。此前尚未有孕妇垂体脓肿的相关描述。一名38岁的孕妇(妊娠34周),患有垂体肿块,主诉渐进性头痛和突然视力障碍。入院时她无发热,也没有炎症症状。磁共振成像(MRI)检查显示,术前诊断为垂体腺瘤伴蝶窦炎。她接受了经蝶窦切除垂体肿块的手术,过程顺利。第二天,她开始分娩,产下了一个健康的早产婴儿。鞍内肿块的病理检查显示有多形核细胞、碎屑,未见肿瘤细胞。对鞍内内容物进行培养,培养出了草绿色链球菌。据我们所知,这是首例妊娠期垂体脓肿的报道。尽管患者处于妊娠期,但经蝶窦手术对母亲和胎儿都是安全的。手术引流和抗生素治疗是该病的确定性治疗方法。