Pediatric abscessed craniopharyngioma: a case report and review of literature - 31/07/24

Doi : 10.1016/j.neuchi.2024.101584

Lamia Benantar, Hajar Hamadi ⁎ , Khalid Aniba
Department of Neurosurgery, Ibn Tofail Hospital, Mohammed VIth University Hospital, Faculty of Medicine and Pharmacy in Marrakech, Cadi Ayyad University, Marrakech, Morocco

^⁎Corresponding author at: Assif C, ELBOUAMRIA N 12, Marrakech, 40000 Morocco.Assif C, ELBOUAMRIA N 12Marrakech40000Morocco

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Highlights

•	Sellar abscesses are rare intrasellar infections with potentially high disability due to local disturbances.
•	The presurgical diagnosis of sellar abscesses is difficult due to non-specific presenting symptoms as well as non-specific imaging findings.
•	The management of these conditions relies on surgical evacuation and antibiotics treatment.
•	Culture of the purulent material is usually negative.

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Abstract

Background

Craniopharyngiomas are rare sellar and suprasellar tumors affecting children and adults. The spontaneous abscessation of this lesion is an extremely rare occurrence with a total of 10 cases reported in the literature including 2 cases in the pediatric population.

Observation

We report a case of abscessed craniopharyngioma in a 10-year-old girl, revealed by intracranial hypertension and diabetes insipidus with a double component (solid and cystic) lesion of the sella visualized on cerebral MRI. The patient underwent surgical decompression via endoscopic endonasal transsphenoidal approach coupled with antibiotic treatment with an uneventful postoperative course and improvement of her symptoms.

Conclusion

Abscessed craniopharyngiomas are rare and challenging entities. We highlight through our case and literature review the importance of an in-depth patient’s history as well as a clinical-radiological correlation in allowing for a positive preoperative diagnosis even in patients with no meningeal or infection signs.

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Abbreviations : CSF, CT, FSH, LH, mL, MRI, SA, T4, TSH, WHO

Keywords : Sellar abscess, Craniopharyngioma, Secondary pituitary abscess, Abscessed craniopharyngioma