Pituitary abscess is a rare condition. It can present with hormonal deficiencies and may affect reproductive health. We present a case of a 43-year-old female presenting with bitemporal hemianopsia and amenorrhea. Imaging of the pituitary showed a sellar-suprasellar mass 2.6 x 2.4 x 1.8 cm with an enhancing nodular component. Pre-operative diagnosis was pituitary adenoma with panhypopituitarism and compression of the optic chiasm. The patient underwent transsphenoidal excision of the tumor. Intraoperative findings revealed purulent fluid consistent with pituitary abscess. There was immediate improvement of vision post operatively. She did not develop diabetes insipidus. Gram stain showed polymorphonuclear (PMN) cells 0-1 per oil immersion field (OIF) and Gram-positive cocci 0-1 per OFI, however there was no growth on culture. The abscess was also negative for acid-fast bacilli and was negative on polymerase chain reaction. Histopathologic evaluation showed benign cyst contents. The patient was treated with ceftriaxone 2 grams every 12 hours for 14 days and was eventually discharged with prednisone and levothyroxine. Pituitary abscess is an important differential diagnosis for sellar and suprasellar masses. There are no specific clinical and radiologic features that will enable a preoperative diagnosis of pituitary abscess.
Amenorrhea

The true incidence and prevalence of congenital Mullerian duct anomalies are difficult to determine. Some patients may present as adolescents with apparent primary amenorrhea, cyclical abdominal pain and sexual difficulties. It is important to ascertain a correct diagnosis for timely and appropriate interventions necessary to prevent sequelae that often affect the future fertility of these patients. This is a case of a fifteen year old with severe cyclical pelvic pain and hematuria with amenorrhea. Work up included a transrectal ultrasound and a magnetic resonance imaging of the pelvis revealing presence of a uterine corpus and cervix but absence of uterine isthmus. A conservative surgical approach was planned. The patient underwent end-to-end anastomosis of the cervix and uterine corpus. At present, the patient is regularly menstruating with no pelvic pain.
Amenorrhea

Recurrent ectopic pregnancy after bilateral salpingectomy is a very rare condition, with only one previous case reported. This is a case of a 29 year old G4P0(0030) who presented with abdominal pain at the background of missed menses and positive pregnancy test, two years after bilateral salpingectomy. Intraoperatively, a 5x4cm bleeding mass was visualized at the right distal tubal remnant, containing an embryo and decidualized tissues. Excision of the adnexal mass and bilateral tubal remnants were completed. In such cases, total salpingectomy is the gold standard in preventing recurrence of another extrauterine gestation. In the presence of tubal remnants, a hysterosalpingography is recommended to assess tubal patency. Ultimately, the rarity of this case demands prompt recognition of risk factors, clinical presentation and appropriate management. It underscores the importance of maintaining vigilance, with high index of clinical suspicion in all women in the reproductive age group, especially those with risk factors.
Amenorrhea

No abstract available.
Amenorrhea* ; Female

No abstract available.
Amenorrhea* ; Female

No abstract available.
Amenorrhea* ; Female

No abstract available.
Amenorrhea* ; Female

No abstract available.
Amenorrhea* ; Female

No abstract available.
Amenorrhea* ; Female

No abstract available.
Amenorrhea* ; Female