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Case Report
Pre-proof, online 4 March 2025
Craniopharyngioma and Abscess: when Tumor and Infection Co-exist
Craneofaringioma y absceso: cuando tumor e infección coexisten
Luis Miguel Moreno-Gómeza,
Corresponding author
lmmg.neurosurgery@gmail.com

Corresponding author.
, Pablo M. Munarriza, Aurelio Hernández-Laínb, Alfonso Lagaresa
a Departamento de neurocirugía en Hospital Universitario 12 de Octubre, Madrid, Spain
b Departamento de anatomía patológica en Hospital Universitario 12 de Octubre, Madrid, Spain
Article information
Abstract

Pituitary abscesses are rare entities that may occur in a previously healthy gland or in the setting of a pituitary tumor. Only eleven cases of abscesses associated with craniopharyngioma have been reported in the literature. The etiology is unknown and the diagnosis is difficult because there are no specific clinical or radiologic features that allow us to suspect the synchrony of both entities before surgery. Intraoperative findings and culture are the only definitive signs to confirm this association.

Here we present the first surgical video showing this unique association and highlighting the technical pearls of the procedure. In a 9-year-old boy, we performed a transphenoidal approach to resect the tumor and saw pus during surgery. Pathology revealed a papillary craniopharyngioma, with microbiology showing Staphylococcus aureus. The tumor resection resulted in ophthalmologic improvement but pituitary insufficiency. A brief review of the literature is presented.

Keywords:
Craniopharyngioma
Pituitary Abscess
Transphenoidal approach
Antibiotics
Staphylococcus aureus
Resumen

Los abscesos hipofisarios son entidades poco frecuentes que pueden aparecer en una glándula previamente sana o asociados a patología tumoral. En la literatura sólo se han descrito once casos de abscesos asociados a craneofaringioma. La etiología es desconocida y el diagnóstico es difícil porque no existen características clínicas o radiológicas específicas que permitan sospechar la sincronía de ambas entidades antes de la cirugía. Los hallazgos intraoperatorios y el cultivo son los únicos signos definitivos para confirmar esta asociación.

Aquí presentamos el primer vídeo quirúrgico que muestra esta asociación única, describiendo los principales pasos quirúrgicos. En un niño de 9 años, realizamos un abordaje transfenoidal para resecar el tumor y observamos pus durante la cirugía. La anatomía patológica reveló un craneofaringioma papilar, y la microbiología mostró un Staphylococcus aureus. La resección del tumor produjo una mejoría oftalmológica pero insuficiencia hipofisaria. Se presenta una breve revisión de la literatura.

Palabras clave:
Craneofaringioma
Absceso pituitario
Abordaje transesfenoidal
Antibióticos
Staphylococcus aureus

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