Primary Aspergillus sellar abscess simulating pituitary tumor in immunocompetent patient

J Craniofac Surg. 2015 Mar;26(2):e86-8. doi: 10.1097/SCS.0000000000001288.

Abstract

A 55-year-old woman presented with headache, dizziness, and decreased visual acuity. Magnetic resonance imaging revealed a sellar mass with sphenoid sinus extension. The result of hormone showed an obviously high prolactin (815 ng/mL). The mass was resected and diagnosed with aspergillosis pathologically. Postoperatively, the level of prolactin dramatically decreased, and the patient received medical treatment with voriconazole and caspofungin. During a 6-month follow-up, the patient's headache and dizziness disappeared, and visual acuity improved. Therefore, aspergillus sellar abscess could result in hyperprolactinemia and should be considered in the differential diagnosis of a sellar mass, even in immunocompetent patients. A combination of surgery and antifungal therapy could reduce the hyperprolactinemia and improve symptoms.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis*
  • Abscess / microbiology
  • Abscess / therapy
  • Antifungal Agents / therapeutic use*
  • Aspergillosis / diagnosis
  • Aspergillosis / microbiology
  • Aspergillosis / therapy
  • Aspergillus / isolation & purification*
  • Diagnosis, Differential
  • Drainage / methods*
  • Female
  • Humans
  • Immunocompromised Host*
  • Magnetic Resonance Imaging
  • Middle Aged
  • Pituitary Diseases / surgery
  • Pituitary Gland / microbiology*
  • Pituitary Neoplasms / diagnosis*
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents