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Pituitary Oct 2015Pituicytoma is a rare tumor arising from the neurohypophysis or pars intermedia of the adenohypophysis.
INTRODUCTION
Pituicytoma is a rare tumor arising from the neurohypophysis or pars intermedia of the adenohypophysis.
CASE REPORT
A 36 year old male came to our observation presenting polydipsia, polyuria, polyphagia, decreased libido and altered sleep-wake rhythm. The biochemical tests showed hypotonic urine, mild hyperprolactinemia, hypogonadotropic hypogonadism, central hypothyroidism. Magnetic resonance revealed an expansive lesion of the suprasellar region (slightly isointense on T1, hyperintense on T2, impregnating contrast medium), that was partially removed by trans-cranial neurosurgical approach. The histopathological diagnosis was pituicytoma. After surgery, in addition to endocrine disorders, the patient presented severe neurological sequelae and hyperthermia, likely due to damage of the hypothalamus, followed by a progressive metabolic syndrome. The residual tumor was monitored by MRI, and, due to the early gradual increase in volume, was treated by stereotactic radiosurgery.
DISCUSSION/CONCLUSIONS
Pituicytomas are often difficult to distinguish from other hypothalamic or pituitary lesions. However, their identification would be preferable in a pre-operative setting in order to optimize the work-up and to initiate a proactive management of the expected complications.
Topics: Adult; Angiography, Digital Subtraction; Humans; Hypophysectomy; Magnetic Resonance Imaging; Male; Neoplasm, Residual; Pituitary Gland, Anterior; Pituitary Neoplasms; Radiosurgery; Reoperation; Treatment Outcome; Tumor Burden
PubMed: 25311104
DOI: 10.1007/s11102-014-0612-7 -
Ryoikibetsu Shokogun Shirizu 2000
Review
Topics: Child; Child, Preschool; Choristoma; Female; Granular Cell Tumor; Humans; Male; Pituitary Diseases; Pituitary Neoplasms
PubMed: 11043233
DOI: No ID Found -
Annals of the Royal College of Surgeons... Apr 2020Pituicytoma is a rare; slow-growing primary tumour originating from the glial cells of the neurohypophysis. It was classed as a low-grade (grade I) central nervous...
BACKGROUND
Pituicytoma is a rare; slow-growing primary tumour originating from the glial cells of the neurohypophysis. It was classed as a low-grade (grade I) central nervous system tumour by the World Health Organization in 2007. We present the case of a 71-year-old man with a previous history of sellar meningioma who underwent surgical resection of pituicytoma by transphenoidal hypophysectomy.
METHOD
We conducted a literature search using Medline EMBASE and the Cochrane Database of Systematic Reviews using the Ovid search engines. Key words searched were 'pituitary gland', 'pituicytoma', 'neurohypophysis'. Patient records and imaging were obtained from the Royal Stoke University Hospital database.
RESULTS
A 71-year-old man with a background of sellar meningioma 16 years previously was found to have a pituitary fossa tumour on surveillance magnetic resonance imaging. Differential diagnosis was pituitary adenoma. Endoscopic transphenoidal hypophysectomy was performed. Histology was consistent with pituicytoma. As a result of this histology from his initial tumour was re-examined and was amended to pituicytoma, indicating a recurrence.
CONCLUSION
Pituicytoma is a benign, slow growing lesion of the posterior pituitary. Brat diagnosed it as a distinct entity in 2000 and it was listed as a World Health Organization classification grade I tumour in 2007. It can be mistaken for pituitary adenoma owing to its similar clinical presentation. Complete excision of the tumour by transphenoidal hypophysectomy is an effective management for pituicytoma as demonstrated in this case.
Topics: Aged; Diagnostic Errors; Humans; Magnetic Resonance Imaging; Male; Meningioma; Neoplasm Recurrence, Local; Pituitary Gland, Posterior; Pituitary Neoplasms; Transanal Endoscopic Surgery; Treatment Outcome
PubMed: 31964155
DOI: 10.1308/rcsann.2020.0004 -
CNS Neuroscience & Therapeutics Jul 2017Pituicytoma is a rare neoplasm of the sella region. Tumor resection is the primary treatment option, but remains subtotal due to excessive bleeding in many cases. The...
INTRODUCTION
Pituicytoma is a rare neoplasm of the sella region. Tumor resection is the primary treatment option, but remains subtotal due to excessive bleeding in many cases. The search for alternative or additional treatment regimens is necessary.
AIMS
We aimed to determine the receptor expression of pituicytoma to find alternatives or supplements to surgical therapy in the use of targeted therapies.
METHODS
Pituicytoma samples were collected from three institutions between 2006 and 2015 and were stained for vascular endothelial growth factors (VEGF), thyroid transcription factor (TTF1), and somatostatin receptors (SSTR 2/3/5). The stains were classified from 0=no staining to +++=strong staining. A complementary retrospective analysis of the patient charts regarding sex, age, and primary symptoms, pituitary function, and perioperative complications was performed.
RESULTS
Ten samples were analyzed; mean patient age was 57.8 years SD 16.3 years. Seven samples were acquired from male patients (one relapse) and three from female. All tumors stained strongly positive (+++) for VEGF-R. Six samples stained positive for TTF1. As for somatostatin receptors, three samples were slightly positive for SSTR 2; seven were negative. SSTR 3 was + in one, three were ++, three were +++, and three were 0. SSTR 5 stained +++ in 1, ++ in 5, + in 1, and 0 in three patients.
CONCLUSIONS
Pituicytomas were generally positive for VEGFR and showed regular expression of SSTR 3 and 5 indicating a possible treatment option through targeted therapies in cases where resection remains insufficient. Further research is necessary as to whether tumor growth can be inhibited using these pathways.
Topics: Adult; Aged; DNA-Binding Proteins; Female; Humans; Intraoperative Complications; Male; Middle Aged; Neoplasm Recurrence, Local; Pituitary Neoplasms; Postoperative Complications; Receptors, Somatostatin; Retrospective Studies; Transcription Factors; Vascular Endothelial Growth Factor A; Young Adult
PubMed: 28556544
DOI: 10.1111/cns.12709 -
Journal of Clinical Neuroscience :... Jul 2010Pituicytoma is a rare, indolent, benign tumor of the sellar and suprasellar region arising from pituicytes of the neurohypophysis. It is most often diagnosed... (Review)
Review
Pituicytoma is a rare, indolent, benign tumor of the sellar and suprasellar region arising from pituicytes of the neurohypophysis. It is most often diagnosed pre-operatively as a pituitary adenoma. We report two patients with pituicytoma operated on at our Institute over 8 years. Imaging of one patient showed a parasellar and medial temporal extension, which has not been reported to our knowledge. The radiological features that help distinguish this low-grade tumor from other sellar and parasellar tumors are discussed along with its distinct histological findings. The authors also review the literature on its clinical presentation, diagnosis, surgical management and outcome.
Topics: Adenoma; Diagnosis, Differential; Female; Humans; Middle Aged; Pituitary Neoplasms; Sella Turcica; Young Adult
PubMed: 20403698
DOI: 10.1016/j.jocn.2009.09.047 -
Pituitary Dec 2012Pituicytoma is an exceptionally rare low-grade glioma (WHO grade I) of the neurohypophysis and infundibulum. We are reporting the case of a 48-year-old man who presented... (Review)
Review
Pituicytoma is an exceptionally rare low-grade glioma (WHO grade I) of the neurohypophysis and infundibulum. We are reporting the case of a 48-year-old man who presented with severe Cushing's syndrome. Endocrinological evaluation unequivocally confirmed pituitary-dependent Cushing's syndrome (=Cushing's disease). Cranial MR-imaging displayed a conspicuous area in the dorsal and basal pituitary gland and a minimal bulging of the pituitary gland paramedian of the pituitary stalk on the right side. Transsphenoidal inspection revealed a small tumor in the basal and dorsal pituitary gland. Surprisingly, the definite postoperative histopathological diagnosis of the removed tumor was pituicytoma and not pituitary adenoma. Hence, the microadenoma responsible for Cushing's disease was not yet removed and persistent hypercortisolism necessitated transsphenoidal re-operation. During re-operation, hemihypophysectomy was performed on the right side. The non-tumorous specimen of the adeno-hypophysis showed signs of Crooke's hyalinization consistent with Cushing's disease. Undetectable postoperative ACTH- and cortisol levels provided clear evidence that the underlying ACTH-source was successfully removed during re-operation. Coincidence of pituicytoma and pituitary-dependent Cushing's disease has not previously been reported.
Topics: Glioma; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pituitary ACTH Hypersecretion; Pituitary Gland, Posterior; Pituitary Neoplasms
PubMed: 20945102
DOI: 10.1007/s11102-010-0262-3 -
Clinical Neuropathology 2010We report on a patient with pituicytoma, i.e. a rare neoplasm of the neurohypophysis, with unusual anamnestic manifestation. (Review)
Review
OBJECTIVE
We report on a patient with pituicytoma, i.e. a rare neoplasm of the neurohypophysis, with unusual anamnestic manifestation.
CASE MATERIAL
After a car accident, the patient suffered from severe persisting headaches. Diagnostic procedures revealed a minor visual impairment and restriction of the gonado- and somatotropic pituitary axis. MRI showed an architecturally solid, well demarcated and homogenous suprasellar lesion. Due to the challenging location of the lesion with a small intrasellar mass and larger suprasellar part within the hypophyseal stalk, a subtotal resection was carried out to save the pituitary function and for neuropathological assessment comprising numerous stainings and immunohistochemical reactions. We observed a highly differentiated, low proliferative, rather cellular and in individual parts moderately pleomorphic tumor with cells arranged in storiform or whorled patterns, that strongly expressed S-100 protein, microtubulus-associated protein 2 (MAP2) and vimentin. Postoperative visual field testing was inconspicuous, but pituitary malfunction was persistent. With respect to the accidental discovery of this pituicytoma, it remains unresolved whether the persisting headache was due solely to the head trauma or was additive with the effects of the pituicytoma.
CONCLUSION
To date less than 30 bona fide examples have been described and typically present symptoms due to mass effects such as visual disturbances, hypopituitarism as well as interference with hypothalamic dopamine release, resulting in subsequent hyperprolactinemia accompanied by decreased libido and amenorrhea in females. These neoplasms represent an important differential diagnosis with respect to suprasellar lesions and a clinical and neuropathological challenge.
Topics: Adenoma; Biopsy; Craniocerebral Trauma; Humans; Incidental Findings; Magnetic Resonance Imaging; Male; Middle Aged; Pituitary Neoplasms
PubMed: 20423685
DOI: 10.5414/npp29127 -
Oncology Letters Nov 2016Pituicytoma is a rare tumor of the sellar and suprasellar regions, arising from the pituicytes, which are specialized glial cells in the neurohypophysis and...
Pituicytoma is a rare tumor of the sellar and suprasellar regions, arising from the pituicytes, which are specialized glial cells in the neurohypophysis and infundibulum. Due to its rarity, ambiguity persists over the diagnosis, management and prognosis of pituicytoma. The current study presents a case series of three patients, each with a histopathological diagnosis of pituicytoma. A summary of the clinical manifestations, radiological characteristics, histopathological features, treatment strategies and prognoses are presented. In addition, 78 cases of pituicytoma, identified in a search of the published literature in Pubmed, are profiled. Pituicytoma typically presents with dysfunction of the optic nerve and pituitary. The radiological characteristics are nonspecific; diagnosis is typically made on the basis of histopathological results. The tumor is slow growing and benign and is amenable to surgical treatment by gross total resection; subsequent tumor recurrence is rare. A definitive assessment of prognosis requires an extended follow-up in a larger cohort.
PubMed: 27900014
DOI: 10.3892/ol.2016.5119 -
Brain Tumor Research and Treatment Oct 2017A 19-year-old man presented with bitemporal hemianopsia and was found to have a large sellar and suprasellar tumor, resembling a pituitary macroadenoma. Emergency...
A 19-year-old man presented with bitemporal hemianopsia and was found to have a large sellar and suprasellar tumor, resembling a pituitary macroadenoma. Emergency transsphenoidal approach was attempted because of rapid visual deterioration with headache. However, the approach was complicated and stopped by uncontrolled hemorrhage from the tumor. After conventional cerebral angiography and recognition of an unusual pathology, transcranial approach was achieved to prevent permanent visual loss. The final pathological diagnosis was pituicytoma with epithelioid features. Pituicytoma is a rare low-grade tumor (WHO Grade I) of pituicytes involving the sellar and suprasellar region, and originating from special glial cells of the neurohypophysis. Because of the high vascularity, the firm consistency, and invasion to surrounding neurovascular structures, a pituicytoma should be included in the differential diagnosis of a mass in the sellar and suprasellar area if the tumor shows high enhancement with vascular components. We report a case of rare pituicytoma mimicking a pituitary macroadenoma with massive hemorrhage to disturb surgery.
PubMed: 29188213
DOI: 10.14791/btrt.2017.5.2.110 -
Pathology Apr 2023
Topics: Humans; ACTH-Secreting Pituitary Adenoma; Pituitary ACTH Hypersecretion; Pituitary Neoplasms; Adenoma; Glioma
PubMed: 36351865
DOI: 10.1016/j.pathol.2022.08.005