PMC5825836_01
Serial magnetic resonance imaging (MRI) examinations performed in the patient. (A and B) Post-contrast T1-weighted view in mid-sagittal plane (A) and coronal T2-weighted view (B) of the initial MRI examination showing a pituitary abscess extending to the floor of 3rd ventricle (arrow in A) surrounded by a 'pyogenic membrane' disclosing T2-weighted hyposignal intensity (arrow in B). (C and D) First follow-up MRI performed 2 months after first surgery showing a decrease in the size of pituitary abscess (arrows) together with a small susceptibility artifact due to micro-clipping (post-contrast T1-weighted (C) and T2-weighted views (D) in coronal plane). (E and F) Follow-up examination performed 4 months after the first surgery showing an increase in size of the pituitary abscess (thicker arrows to be compared to those in C and D) (post-contrast T1-weighted (E) and T2-weighted views (F) in coronal plane). (G and H) Control examination 2 months after second surgery showing a roll of Gelfoam within the remaining abscess cavity, which has been evacuated (post-contrast T1-weighted (G) and T2-weighted views (H) in coronal plane).
edmcr-2018-170162-g001.jpg
PMC5825836_01_edmcr-2018-170162-g001.jpg
fig1
Repeat MRI showed disease progression with significant enlargement of the necrotic pituitary gland contacting the optic chiasm, as well as an enlargement of the pituitary stalk and contrast retention within the hypothalamus, thus suggesting extension of the inflammatory process (Fig. 1A and B).