PMC8720480_01
Brain magnetic resonance imaging scans. (a) Coronal postgadolinium T1-weighted image, (b) sagittal postgadolinium T1-weighted image, (c) axial diffusion-weighted image, and (c') the enlarged pituitary part of diffusion-weighted image of c. (a-c') Magnetic resonance imaging showing pituitary enlargement with heterogeneous enhancement and thickened pituitary stalk compressing the optic chiasma. There is no high signal on diffusion-weighted imaging, indicating lack of diffusion restriction. (d) Yellow and creamy pus observed intraoperatively (arrow).
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F1
Neither ring enhancement nor diffusion restriction was observed [Figure 1a-c]. Endoscopic endonasal transsphenoidal surgery was performed, and a thick, creamy yellow pus was drained out of the sellar lesion [Figure 1d].
The pathological result shows a predominance of polymorphonuclear leukocytes, but no tumor cells. (a) 200x and (b) 400x.
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F2
The intraoperative rapid pathological findings showed polymorphonuclear leukocytes infiltrating the pituitary gland and no tumor cells, also reaffirmed by postoperative pathological results [Figure 2a and b].
Brain magnetic resonance imaging scans. (a) Coronal postgadolinium T1-weighted image, (b) sagittal postgadolinium T1-weighted image, (c) sagittal diffusion-weighted image. (a-c) Postoperative magnetic resonance imaging showing no apparent change from preoperative magnetic resonance imaging (MRI) scan. There is no high signal on diffusion-weighted imaging as same as preoperative MRI scan.
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F3
PA and subsequently performed irrigation and drainage of the abscess. Postoperative MRI revealed no apparent change from preoperative MRI [Figure 3a-c].