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Secondary headache due to aspergillus sellar abscess simulating a pituitary neoplasm: case report and review of literature.

Hong W, Liu Y, Chen M, Lin K, Liao Z, Huang S - Springerplus (2015)

Bottom Line: Milk-like pus and a mass of ash black mixed and necrotic material were found and removed.Histopathology revealed numerous aspergillus hyphae.No recurrence was observed during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Fujian Provincial Hospital, Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, 350001 China.

ABSTRACT
Fungal sellar abscess is rare. A 42-year-old man was admitted with 2-month headache characterized by right peri-orbital pain. An intrasellar mass was found to be simulated a pituitary neoplasm after magnetic resonance imaging examination, and operated on via an endoscopic trans-sphenoidal approach. Milk-like pus and a mass of ash black mixed and necrotic material were found and removed. Histopathology revealed numerous aspergillus hyphae. Itraconazole was given on a dosage of 200 mg twice a day orally for 6 weeks. No recurrence was observed during follow-up. Complete surgical resection through endoscopic trans-sphenoidal approach combined with systemic anti-fungal therapy, should be considered as the optimal treatment.

No MeSH data available.


Related in: MedlinePlus

a On T2 weighted image, the central part of the mass was hypo-intense, the peripheral part was hyper-intense; b contrast enhanced T1-weighted MRI showed the mass was of slight rim enhancement. The sella turcica was enlarged and the sphenoidal sinus was greatly diminished
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Fig1: a On T2 weighted image, the central part of the mass was hypo-intense, the peripheral part was hyper-intense; b contrast enhanced T1-weighted MRI showed the mass was of slight rim enhancement. The sella turcica was enlarged and the sphenoidal sinus was greatly diminished

Mentions: A 42-year-old man was admitted with headache and diplopia of 2 days duration in December 2014. The feature of headache was persistent and electric shock-like peri-orbital pain on the right side, without nausea and vomit. He was engaged in fungus mushroom cultivation for 3 years. His medical history was insignificant. Neurological examination showed the right abducens nerve palsy. T2-weighted MRI revealed an heterogenous intrasellar mass (Fig. 1a). Contrast enhanced T1-weighted MRI showed the mass was of slight rim enhancement (Fig. 1b). Levels of endocrinological workup were all within normal limits. Before operation, headache could not be controlled by the drug of mannitol and NSAIDs except oxcarbazepin.Fig. 1


Secondary headache due to aspergillus sellar abscess simulating a pituitary neoplasm: case report and review of literature.

Hong W, Liu Y, Chen M, Lin K, Liao Z, Huang S - Springerplus (2015)

a On T2 weighted image, the central part of the mass was hypo-intense, the peripheral part was hyper-intense; b contrast enhanced T1-weighted MRI showed the mass was of slight rim enhancement. The sella turcica was enlarged and the sphenoidal sinus was greatly diminished
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4582039&req=5

Fig1: a On T2 weighted image, the central part of the mass was hypo-intense, the peripheral part was hyper-intense; b contrast enhanced T1-weighted MRI showed the mass was of slight rim enhancement. The sella turcica was enlarged and the sphenoidal sinus was greatly diminished
Mentions: A 42-year-old man was admitted with headache and diplopia of 2 days duration in December 2014. The feature of headache was persistent and electric shock-like peri-orbital pain on the right side, without nausea and vomit. He was engaged in fungus mushroom cultivation for 3 years. His medical history was insignificant. Neurological examination showed the right abducens nerve palsy. T2-weighted MRI revealed an heterogenous intrasellar mass (Fig. 1a). Contrast enhanced T1-weighted MRI showed the mass was of slight rim enhancement (Fig. 1b). Levels of endocrinological workup were all within normal limits. Before operation, headache could not be controlled by the drug of mannitol and NSAIDs except oxcarbazepin.Fig. 1

Bottom Line: Milk-like pus and a mass of ash black mixed and necrotic material were found and removed.Histopathology revealed numerous aspergillus hyphae.No recurrence was observed during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Fujian Provincial Hospital, Fujian Medical University, 134 Dongjie Road, Gulou District, Fuzhou, 350001 China.

ABSTRACT
Fungal sellar abscess is rare. A 42-year-old man was admitted with 2-month headache characterized by right peri-orbital pain. An intrasellar mass was found to be simulated a pituitary neoplasm after magnetic resonance imaging examination, and operated on via an endoscopic trans-sphenoidal approach. Milk-like pus and a mass of ash black mixed and necrotic material were found and removed. Histopathology revealed numerous aspergillus hyphae. Itraconazole was given on a dosage of 200 mg twice a day orally for 6 weeks. No recurrence was observed during follow-up. Complete surgical resection through endoscopic trans-sphenoidal approach combined with systemic anti-fungal therapy, should be considered as the optimal treatment.

No MeSH data available.


Related in: MedlinePlus