Intrachiasmatic abscess caused by IgG4-related hypophysitis

Acta Neurochir (Wien). 2017 Nov;159(11):2229-2233. doi: 10.1007/s00701-017-3288-8. Epub 2017 Aug 10.

Abstract

Introduction: Autoimmune hypophysitis is a rare disease of the pituitary, which may affect vision by inflammation and compression of the optic chiasm. However, intrachiasmatic abscess formation has not been previously reported.

Methods: In this study, we report a case of a 29-year-old female with bitemporal hemianopia due to a cystic intrasellar tumor. The patient underwent surgical decompression of the lesion, which was found to be an intrachiasmatic abscess.

Results: The histologic findings were consistent with IgG4 hypophysitis.

Conclusion: This rare clinical presentation suggests that in case of a disproportionate degree of visual impairment in relation to the size of the lesion, suspicion should lead to an intrachiasmatic lesion.

Keywords: Abscess; Hypophysitis; IgG4; Intrachiasmatic.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoimmune Hypophysitis / complications
  • Autoimmune Hypophysitis / diagnostic imaging*
  • Autoimmune Hypophysitis / pathology
  • Autoimmune Hypophysitis / surgery
  • Brain Abscess / complications
  • Brain Abscess / diagnostic imaging*
  • Brain Abscess / pathology
  • Brain Abscess / surgery
  • Decompression, Surgical
  • Female
  • Hemianopsia / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Neurosurgical Procedures
  • Optic Chiasm / diagnostic imaging*
  • Optic Chiasm / surgery