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The American Journal of Surgical... Mar 2000Pituicytoma is a rare, poorly characterized tumor of the sella and suprasellar region that is distinct morphologically from other local tumors and is thought to be...
Pituicytoma is a rare, poorly characterized tumor of the sella and suprasellar region that is distinct morphologically from other local tumors and is thought to be derived from neurohypophyseal pituicytes. Clinical data, neuroimaging studies, and microsections were reviewed from nine such low-grade gliomas. Immunostains for glial, neuronal, and proliferation markers were performed on all nine tumors and six control neurohypophyses. Three tumors were studied ultrastructurally. Six men and three women, age 30 to 83 years (mean, 48 years), presented with visual symptoms, headache, or hypopituitarism. Magnetic resonance images showed solid, discrete, contrast-enhancing masses, four within the sella and five in the suprasellar space. The tumors consisted of sheets and/or fascicles of plump spindle cells with slightly fibrillar cytoplasm and slightly pleomorphic, oval-to-elongate nuclei with pinpoint nucleoli. Extracellular mucin was prominent in one tumor. Rosenthal fibers, granular bodies, and Herring bodies (granular axonal dilatations characteristic of the normal neurohypophysis) were lacking. Mitoses were rare or absent. MIB-1 labeling indices were low (0.5-2%). Tumor cells were strongly reactive for vimentin and S-100 protein, variably positive for glial fibrillary acidic protein, and nonreactive for synaptophysin and neurofilament protein. Cytoplasm varied in electron density and contained intermediate filaments. Neither meningothelial nor ependymal features were noted. Two tumors recurred at 20 and 26 months after subtotal resection, but none of the six completely resected tumors have done so. Pituicytomas are discrete, largely noninfiltrative low-grade gliomas of the sellar region that occur in adults. Their histologic appearance is distinct from pilocytic and ordinary, infiltrative astrocytomas. The distinction between pituicytoma and normal neurohypophysis is aided by the latter's content of axons, Herring bodies, and perivascular anucleate zones rich in axonal terminations. Although curable by total excision, subtotal resection can be associated with recurrence.
Topics: Adult; Aged; Aged, 80 and over; Female; Glioma; Humans; Male; Middle Aged; Pituitary Gland, Posterior; Pituitary Neoplasms; Sella Turcica
PubMed: 10716149
DOI: 10.1097/00000478-200003000-00004 -
Indian Journal of Pathology &... 2013
Topics: Adult; Head; Histocytochemistry; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Pituitary Neoplasms; Radiography
PubMed: 24056664
DOI: 10.4103/0377-4929.118695 -
British Journal of Neurosurgery Feb 2007
Topics: Aged; Astrocytoma; Craniopharyngioma; Humans; Magnetic Resonance Imaging; Male; Pituitary Gland, Posterior; Pituitary Neoplasms; Prognosis
PubMed: 17453778
DOI: 10.1080/02688690701218375 -
La Radiologia Medica Mar 2020Hypophysitis (HP) is a rare acute or chronic inflammatory condition of the pituitary gland. The greatest challenge in the management of HP is establishing a diagnosis... (Review)
Review
Hypophysitis (HP) is a rare acute or chronic inflammatory condition of the pituitary gland. The greatest challenge in the management of HP is establishing a diagnosis through clinical criteria and non-invasive methods and predicting the patients' clinical outcome. The aim of this review is to describe the neuroradiological findings of this rare disease, providing some information regarding the possible differential diagnosis in order to avoid unnecessary surgery. Gadolinium-enhanced pituitary magnetic resonance imaging (MRI) is considered the neuroradiological investigation of choice. The features suggestive for HP include an enlarged triangular- or dumbbell-shaped gland with a thickened and not obviously deviated stalk, further supported by the absence of posterior pituitary bright spot on T1weighted images, particularly in patients presenting with diabetes insipidus. Contrast enhancement pattern is quite variable; dural enhancement has been reported in some cases after intravenous contrast administration. The characterization of the unusual sellar mass is not straightforward and generally results in a wide differential. HP should be primarily differentiated from pituitary adenomas (including pituitary apoplexy), from pituitary metastases, and from other sellar and parasellar tumors, e.g., craniopharyngiomas, germinomas, gliomas, lymphomas, meningiomas, pituicytomas, chordomas, teratomas, dermoids and epidermoids, Rathke's cleft cysts, and abscesses. In patients suspected for secondary forms related to systemic pathology, additional imaging is helpful in identifying other involved sites. Neuroradiologists need to know MRI appearance of this rare disease, as well as its typical symptoms and serological markers. A strict collaboration with endocrinologists and neurosurgeons is mandatory in order to reach a definitive diagnosis, allowing to promptly initiating an appropriate treatment.
Topics: Adenoma; Autoimmune Hypophysitis; Contrast Media; Diagnosis, Differential; Gadolinium; Humans; Hypophysitis; Immunoglobulin G4-Related Disease; Magnetic Resonance Imaging; Neuroradiography; Pituitary Gland; Pituitary Neoplasms; Xanthomatosis
PubMed: 31863360
DOI: 10.1007/s11547-019-01120-x -
AJNR. American Journal of Neuroradiology Sep 2006We report a case of pituicytoma, a rare primary tumor of the neurohypophysis. A 64-year-old man presented with progressive visual complaints, bitemporal hemianopsia, and...
We report a case of pituicytoma, a rare primary tumor of the neurohypophysis. A 64-year-old man presented with progressive visual complaints, bitemporal hemianopsia, and headache. Imaging studies revealed distinctive features of a mass lesion that thickened the pituitary stalk with a bilobed protrusion extending into the hypothalamus. Angiography demonstrated tumor vascular supply from the superior hypophyseal arteries representing the diencephalic branches of the internal carotid arteries. We discuss the imaging and pathology of this unusual tumor.
Topics: Astrocytoma; Carotid Artery, Internal; Cerebral Angiography; Diagnosis, Differential; Diplopia; Headache; Hemianopsia; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Microsurgery; Middle Aged; Pituitary Gland; Pituitary Neoplasms
PubMed: 16971602
DOI: No ID Found -
Archives of Pathology & Laboratory... Jul 2010The pituicytoma is a rare neoplasm whose histogenesis is debated partly because of the diversity of tissue types present in the sellar region. In this article we...
The pituicytoma is a rare neoplasm whose histogenesis is debated partly because of the diversity of tissue types present in the sellar region. In this article we illustrate the characteristic histologic, immunohistologic, and ultrastructural features of this unique neoplasm. Furthermore, we use array-based comparative genomic hybridization to demonstrate a unique pattern of genomic copy number aberrations in pituicytomas. Tumors were composed of bipolar, spindle cells that were immunopositive for S100, vimentin, and Bcl-2 and immunonegative for synaptophysin, chromogranin, and glial fibrillary acidic protein. Ultrastructural analysis was remarkable for absence of secretory granules. Array comparative genomic hybridization demonstrated genomic copy number imbalances, including losses on chromosome arms 1p, 14q, and 22q and gains on 5p. This pattern of genetic changes only partially overlaps with the genomic alterations reported in pituitary adenomas. In summary, our data suggest that pituicytomas are a unique subset of tumors of the sellar region.
Topics: Chromosome Mapping; Comparative Genomic Hybridization; Female; Gene Dosage; Humans; Immunohistochemistry; Male; Middle Aged; Pituitary Neoplasms; Rare Diseases; Secretory Vesicles
PubMed: 20586639
DOI: 10.5858/2009-0167-CR.1 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Sep 2017
PubMed: 28910880
DOI: 10.3760/cma.j.issn.0529-5807.2017.09.014 -
Oncology Letters Jul 2018Pituicytomas are a rare form of indolent neoplasms, which typically present with visual disturbance and hypopituitarism. Complete resection by a trans-sphenoidal...
Pituicytomas are a rare form of indolent neoplasms, which typically present with visual disturbance and hypopituitarism. Complete resection by a trans-sphenoidal approach is the optimal treatment. Only 80 cases have been described thus far in the current literature and the present case is the first to describe the development of pituitary apoplexy in the context of a pituicytoma. A 77-year-old man presented with fatigue and clinical signs of hypogonadism and a sellar lesion was diagnosed at cerebral magnetic resonance imaging (MRI). A watch-and-wait management was initially decided and 1 year after the initial diagnosis, he presented with a thunderclap headache with images suggestive of pituitary apoplexy. A pituitary adenoma was suspected and an endoscopic resection was decided upon the development of a visual deficit. Pathological analysis established the correct diagnosis of a pituicytoma. Pituicytomas are characterised by dense vascularisation, thus ischaemic and haemorrhagic events may be common. When confronted with a hypervascularised pituitary lesion demonstrating strong contrast enhancement and no abnormal hormonal secretion, one must maintain a high index of suspicion for a pituicytoma. A wide range of differential diagnoses should thus be considered in the context of pituitary apoplexy.
PubMed: 29928451
DOI: 10.3892/ol.2018.8625 -
Neurosurgery Mar 2004The pituicytoma is a rare primary tumor of the neurohypophysis. Although histologically benign, the location and vascular nature of these tumors can make surgical...
OBJECTIVE AND IMPORTANCE
The pituicytoma is a rare primary tumor of the neurohypophysis. Although histologically benign, the location and vascular nature of these tumors can make surgical resection difficult. We present a report of two patients with pituicytomas and review the literature regarding treatment and prognosis for this unusual lesion. Possible histogenetic relationships of this tumor with other pituitary neoplasms are presented.
CLINICAL PRESENTATION
Patient 1 was a 45-year-old man who presented with a 5-year history of decreased libido. He was found to have a 2-cm suprasellar mass on a magnetic resonance imaging scan. Patient 2 was a 48-year-old man who presented with multiple endocrine complaints. He was found to have an intrasellar mass on magnetic resonance imaging.
INTERVENTION
Patient 1 underwent a right frontal craniotomy, with a subtotal resection of the suprasellar mass through the lamina terminalis. The residual tumor was treated with fractionated stereotactic radiotherapy. The intrasellar mass in Patient 2 was resected via a transsphenoidal approach. On surveillance magnetic resonance imaging, the tumor was found to have recurred and expanded into the suprasellar space. The patient underwent a right frontal craniotomy for decompression and a subtotal resection of the tumor. The patient experienced a second recurrence 7 years after the initial procedure and was subsequently treated with fractionated stereotactic radiotherapy.
CONCLUSION
Pituicytomas are a distinct form of pituitary gland neoplasia that may recur if subtotally resected. These neurohypophysial tumors may contain a small subpopulation of previously unrecognized bcl-2-immunoreactive cells, whose role in the histogenesis of pituicytoma deserves further study.
Topics: Adenoma; Adult; Biomarkers, Tumor; Cell Transformation, Neoplastic; Combined Modality Therapy; Diagnosis, Differential; Glial Fibrillary Acidic Protein; Glioma; Humans; Magnetic Resonance Imaging; Male; Microscopy, Electron; Middle Aged; Neoplasm Recurrence, Local; Pituitary Gland, Anterior; Pituitary Gland, Posterior; Pituitary Irradiation; Pituitary Neoplasms; Proto-Oncogene Proteins c-bcl-2; Radiosurgery; Radiotherapy, Adjuvant; Reoperation; Stem Cells; Vimentin
PubMed: 15028154
DOI: 10.1227/01.neu.0000108983.50966.b7 -
Diagnostic Cytopathology Oct 2005The crush cytology of a pituicytoma is reported. The lesion was resected from a 54-yr-old man with a 7-mo history of headache. The intraoperative crush smears revealed...
The crush cytology of a pituicytoma is reported. The lesion was resected from a 54-yr-old man with a 7-mo history of headache. The intraoperative crush smears revealed plump spindle cells with elongated, nonwavy nuclei, and moderate, finely granular cytoplasm with distinct cytoplasmic borders. These cells were arranged in cohesive fascicles exhibiting a storiform pattern focally. Cytologically, this lesion can be differentiated from pituitary adenoma, astrocytoma, meningioma, and schwannoma.
Topics: Cytodiagnosis; Glioma; Humans; Intraoperative Period; Magnetic Resonance Imaging; Male; Middle Aged; Pituitary Gland, Posterior; Pituitary Neoplasms; Treatment Outcome
PubMed: 16138377
DOI: 10.1002/dc.20352