CASE REPORT
Introdução: Relatamos um caso de abscesso hipofisário simulando recorrência de craniofaringioma em paciente com duas ressecções prévias. As abordagens cirúrgicas e o novo tratamento com reservatório de Ommaya, além das teorias a respeito da origem dessas lesões e seu tratamento são discutidas. Apresentação do caso: Paciente masculino, 34 anos, com diagnóstico de craniofaringioma recorrente, apresentou cefaleia persistente, amaurose em olho esquerdo e redução da acuidade visual em olho direito. Exame de imagem sugeriu recidiva tumoral. Abordagem cirúrgica evidenciou abscesso, o qual foi drenado e confirmado por estudo anatomopatológico. Realizada instalação de cateter intralesional, conectado a um reservatório de Ommaya para futura drenagem do conteúdo da lesão e instilação de antimicrobianos ou quimioterápicos. Conclusão: Abscessos secundários a craniofaringiomas são raros, com poucos relatos na literatura. A utilização do reservatório de Ommaya parece ser uma alternativa para o tratamento durante o seguimento dos pacientes.
Introduction: A case of pituitary abscess mimicking craniopharyngioma recurrence in a patient with two previous resections is reported. Surgical approaches and the new approach with Ommaya reservoir, as well as theories about the origin of these lesions and their therapy were discussed. Case presentation: A 34-year-old male patient diagnosed with recurrent craniopharyngioma presented with persistent headache, left eye amaurosis and right eye visual acuity deterioration. Imaging exam was suggestive of tumoral lesion recurrence. Surgical approach evidenced an abscess-like lesion which was drained and confirmed by pathological study. Intralesional catheter was inserted connected to Ommaya reservoir for future drainage of lesion contents and administration of antimicrobials or chemotherapeutic agents. Conclusion: Abscesses secondary to craniopharyngiomas are rare with few reports in the literature. The usage of Ommaya reservoir seems to be an alternative for treatment during patient follow-up.
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1 MD, Graduated, Medical School, Assis Gurgacz University Center, Cascavel, PR, Brazil.
2 MD, MR, Medical Residency in Neurosurgery, São Lucas Hospital Foundation, Cascavel, PR, Brazil.
3 MD, Neurosurgeon, Neuroanatomy Professor, Medical School, Assis Gurgacz University Center, Cascavel, PR, Brazil.
4 MD, MSc. Neurosurgeon, Coordinator of Medical Residency in Neurosurgery, São Lucas Hospital Foundation, Cascavel, PR, Brazil.
Received Dec 29, 2021
Accepted Feb 2, 2022
