Morning glory syndrome associated with transsphenoidal encephalocele and panhypopituitarism.

ent diffusion coefficient (ADC), from necrotic tumors, which show a low diffusion signal with high ADC. The final diagnosis is usually histological after surgical drainage. Coagulase-negative Staphylococcus is the most commonly isolated microorganism. According to the different series, the ratio between Gram stain and positive cultures ranges from 0% to 64%, which may first be explained by the low activity of bacteria in pituitary abscesses, and second, by preoperative antibiotic therapy. The treatment of choice consists of transsphenoidal surgical drainage and antibiotic therapy for 3--6 weeks. However, conservative antibiotic therapy may be useful for early pituitary abscesses. Visual deficiencies usually improve after treatment, but endocrine deficiencies may persist and require permanent replacement therapy. The recurrence rate is low, but MRI monitoring is advisable in order to detect recurrent abscess. In conclusion, it can be said that preoperative diagnosis of pituitary abscess is difficult because of its insidious clinical signs and symptoms and poorly specific radiographic findings. Pituitary abscess should be suspected in a patient with a cystic sellar mass with ring-shaped enhancement, particularly when associated with clinical signs of infection and/or diabetes insipidus. Because of the low frequency of pituitary abscess, we would like to see a multicenter study with a larger patient sample being conducted, with the aim of furthering our understanding of this condition.