• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1098-1102
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• 2000

Pituitary abscess is a very rare disorder, since antibiotics therapy has become widely available. Clinically and radiologically, the preoperative diagnosis of pituitary abscess is difficult because of its features which may be identical to those of any space-occupying lesions of the sella turcica. A combination of clinical features, such as meningitis, paranasal sinusitis and panhypopituitarism with intrasellar cystic lesion with homogeneous ring enhancement on computed tomography or magnetic resonance image should raise the suspicion of a pituitary abscess. Drainage of the abscess through trans-sphenoidal approach, appropriate antibiotics therapy, endocrine assessment and hormonal replacement should bring complete recovery to the patient. The authors review the literature and report two cases of primary pituitary abscess.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.555-557
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• 2012

We report an uncommon case of a 45-year-old woman who presented with spontaneous rhinorrhea. A computed tomography (CT) scan of the head revealed an abnormally large sphenoid sinus associated with a parasellar bony defect (Sternberg's canal) through which magnetic resonance imaging could detect an encephalocele of the right temporal lobe. An endoscope-assisted trans-sphenoidal approach was performed and, with the aid of image guided surgery, reduction of the encephalocele was obtained and followed by surgical repair of the dural and bony defects. The postoperative course was uneventful and the cerebrospinal fluid fistula was closed as confirmed by the postoperative CT scan and by the absence of rhinorrhea. After three years of monitoring the patient remained asymptomatic.

• Journal of Korean Neurosurgical Society
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• v.54 no.4
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• pp.317-322
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• 2013

Objective : The surgical approach for recurrent pituitary adenoma after trans-sphenoidal approach (TSA) is challenging. We report the outcomes of the endoscopic TSA for recurrent pituitary adenoma after microscopic TSA. Methods : From February 2010 to February 2013, endoscopic TSA was performed for removal of 30 recurrent pituitary adenomas after microscopic TSA. Twenty-seven (90%) patients had a clinically non-functioning pituitary adenoma. Twenty-four (80%) patients suffered from a visual disturbance related to tumor growth. The clinical features and surgical outcomes were retrospectively analyzed for the ophthalmological, endocrinological, and oncological aspects. Results : The mean tumor volume was 11.7 $cm^3$, and gross total resection was achieved in 50% of patients. The volumetric analysis based on the postoperative MR showed that the mean extent of resection rates were 90%. Vision was improved in 19 (79%) of 24 patients with visual symptoms, and endocrinological cure was achieved in all of three functioning pituitary adenomas; however, the post-operative follow-up endocrinological examination revealed a new endocrinological deficit in one patient. Two patients required antibiotics management for post-operative meningitis. Conclusion : The endoscopic TSA can be an effective treatment option for recurrent pituitary adenoma after microscopic TSA with acceptable outcome.

• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.83-88
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• 2007

Objective : Pituitary apoplexy, resulting from an acute infarction or hemorrhage mainly in pituitary adenomas, is a rare yet major clinical event with neurological, ophthalmological and hormonal emergent consequences. The authors review our surgical experience with a series of 16 cases of pituitary apoplexy. Methods : The cases of pituitary apoplexy, operated via trans-sphenoidal approach in our hospital between 1998-2005, were retrospectively analyzed in terms of their clinicoradiological features, pathological findings and surgical outcomes. Results : The mean age of patients (9 male and 7 female) was 47.1 years. The average time of presentation after onset of symptom was 8.9 days. Pituitary apoplexy occurred as an initial manifestation of pituitary adenoma in all patients. Headache was the most common presenting symptom (94%). Visual disturbance was found in 56% of patients. Thirty-one percent of the patients had hypopituitarism. On magnetic resonance imaging, this entire catastrophic event accompanied with macroadenoma in a mean size of 22.5 mm. Only four patients needed postoperative hormone replacement therapy. Three of them showed preoperative hypopituitary function, and one patient in normal pituitary function. There was no specific complication in any of these patients. Conclusion : Early trans-sphenoidal decompression with high-dose corticosteroid replacement showed good outcomes of pituitary apoplexy.