ArticleJournal of neurosurgery. Case lessons2026
Expanded endoscopic endonasal transsphenoidal resection of a rare concurrent sellar pituitary adenoma and suprasellar abscess: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe coexistence of pituitary adenoma and sellar abscess is exceedingly rare, posing diagnostic challenges due to nonspecific clinical and imaging features. OBSERVATIONS: A 47-year-old female presented with a 6-month progressive visual decline. MRI revealed a 2.5-cm multicystic sellar-suprasellar lesion with irregular rim enhancement, suspicious for adenoma or craniopharyngioma. Endoscopic endonasal resection revealed typical adenoma tissue in the sellar region and a suprasellar abscess with thick yellow pus. Both lesions were completely resected in a single stage. Histopathological analysis confirmed nonfunctioning pituitary adenoma with concurrent acute suppurative inflammation. Cultures were negative. The patient received 6 weeks of intravenous antibiotic therapy. Postoperatively, transient diabetes insipidus and fever resolved spontaneously. At the 6-month follow-up, MRI showed complete resection with no recurrence, and the patient's vision significantly improved. LESSONS: Pituitary abscess can rarely coexist with adenoma and mimic common sellar lesions. Single-stage endoscopic endonasal surgery enables simultaneous diagnosis and management of both pathologies. Prolonged antibiotic therapy based on histopathological evidence is essential even with negative cultures. https://thejns.org/doi/10.3171/CASE26194.
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