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Clinical Neurology and Neurosurgery Apr 2021Pituicytoma is a rare subtype of WHO grade I glioma that originates in the neurohypophysis or infundibulum. Here we presented 3 cases of histopathologically diagnosed... (Review)
Review
Pituicytoma is a rare subtype of WHO grade I glioma that originates in the neurohypophysis or infundibulum. Here we presented 3 cases of histopathologically diagnosed pituicytoma and subsequently performed a corresponding systematic literature review. A comprehensive literature search of the PubMed database was conducted. A total of 77 studies were eventually reviewed and 168 pituicytoma cases were identified. The epidemiology, clinical manifestations, radiological features, treatment, and pathological findings of all previous pituicytoma cases were summarized, and a "portrait" of this rare tumor was shown. It is hoped that the current study will afford a broader and more adequate understanding upon this rare disease.
PubMed: 33971477
DOI: 10.1016/j.clineuro.2021.106650 -
Neurology India 2021
Review
Topics: Craniopharyngioma; Glioma; Humans; Male; Pituitary Neoplasms
PubMed: 34979717
DOI: 10.4103/0028-3886.333522 -
Hormones (Athens, Greece) Dec 2021Pituicytoma is a rare tumor of the pituitary gland derived from neurohypophyseal pituicytes. CASE 1: A 58-year-old female presented with decreased vision; she was... (Review)
Review
INTRODUCTION
Pituicytoma is a rare tumor of the pituitary gland derived from neurohypophyseal pituicytes. CASE 1: A 58-year-old female presented with decreased vision; she was admitted to the neurosurgery department of Ege University after the detection of a pituitary macroadenoma. Magnetic resonance imaging (MRI) showed a 28 * 18 * 17-mm suprasellar mass, and laboratory tests revealed hypopituitarism. Hydrocortisone and L-thyroxine treatment were initiated, and the patient underwent resection through the endoscopic endonasal approach (EEA). The histopathological examination revealed a pituicytoma. The recurrence of tumor was detected during the 1-year follow-up, and the patient is awaiting surgery. CASE 2: A 70-year-old woman presented with visual changes; she had a past medical history of hypophyseal macroadenoma and pituicytoma resected through an EEA in 2012 and 2017, respectively. During follow-up, 2 years after the second surgery, MRI showed progression of the pituicytoma then measuring 38 × 23 × 22 mm; it had invaded the cavernous sinus and was causing hydrocephaly and panhypopituitarism. The patient underwent the third resection through the transcranial approach in order to minimize bleeding. After this surgery, the patient developed diabetes insipidus and underwent treatment with desmopressin. Histopathological examination revealed a pituicytoma. At 6-month follow-up, imaging showed a sellar suprasellar mass 37 × 22 × 24 mm invading the cavernous sinus, indicative of recurrence. In the postoperative period, the patient applied to the department of radiation oncology to have fractionated radiotherapy.
DISCUSSION
Pituicytomas are known to be low-grade tumors; because of their rarity, they are a real challenge. These patients should be followed up closely.
Topics: Aged; Female; Glioma; Humans; Magnetic Resonance Imaging; Middle Aged; Pituitary Gland; Pituitary Neoplasms
PubMed: 34390481
DOI: 10.1007/s42000-021-00301-6 -
World Neurosurgery Jul 2012Pituicytomas are rare tumors of the sellar region that are derived from specialized glial cells called pituicytes. They characteristically exhibit spindle-cell features... (Review)
Review
BACKGROUND
Pituicytomas are rare tumors of the sellar region that are derived from specialized glial cells called pituicytes. They characteristically exhibit spindle-cell features and fascicular or storiform patterns of growth. No other histological variants of this tumor have been described.
CASE DESCRIPTION
Here we report a diagnostically challenging case of pituicytoma in a 42-year-old man with a sellar mass arising from the pituitary stalk. On histological examination, the tumor displayed an epithelioid histoarchitecture with no characteristic spindle-cell or fascicular growth features. Strong immunopositivity for the pituicyte marker thyroid transcription factor-1 within tumor cells proved essential for diagnosing this unusual pituicytoma variant.
CONCLUSION
Pituicytomas may display epithelioid rather than fascicular or storiform histoarchitecture. Epithelioid pituicytoma variants may be diagnosed in cases such as ours in which both the clinical findings and immunohistochemical analysis suggest a tumor derived from pituicytes.
Topics: Adult; Biomarkers, Tumor; Craniotomy; Diagnosis, Differential; Epithelioid Cells; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Pituitary Gland; Pituitary Neoplasms
PubMed: 22120271
DOI: 10.1016/j.wneu.2011.09.011 -
Endocrine Pathology Mar 2022This review summarizes the changes in the 5th Edition of the WHO Classification of Endocrine and Neuroendocrine Tumors that relate to the pituitary gland. The new... (Review)
Review
This review summarizes the changes in the 5th Edition of the WHO Classification of Endocrine and Neuroendocrine Tumors that relate to the pituitary gland. The new classification clearly distinguishes anterior lobe (adenohypophyseal) from posterior lobe (neurohypophyseal) and hypothalamic tumors. Other tumors arising in the sellar region are also discussed. Anterior lobe tumors include (i) well-differentiated adenohypophyseal tumors that are now classified as pituitary neuroendocrine tumors (PitNETs; formerly known as pituitary adenomas), (ii) pituitary blastoma, and (iii) the two types of craniopharyngioma. The new WHO classification provides detailed histological subtyping of a PitNET based on the tumor cell lineage, cell type, and related characteristics. The routine use of immunohistochemistry for pituitary transcription factors (PIT1, TPIT, SF1, GATA3, and ERα) is endorsed in this classification. The major PIT1, TPIT, and SF1 lineage-defined PitNET types and subtypes feature distinct morphologic, molecular, and clinical differences. The "null cell" tumor, which is a diagnosis of exclusion, is reserved for PitNETs with no evidence of adenohypophyseal lineage differentiation. Unlike the 2017 WHO classification, mammosomatotroph and acidophil stem cell tumors represent distinct PIT1-lineage PitNETs. The diagnostic category of PIT1-positive plurihormonal tumor that was introduced in the 2017 WHO classification is replaced by two clinicopathologically distinct PitNETs: the immature PIT1-lineage tumor (formerly known as silent subtype 3 tumor) and the mature plurihormonal PIT1-lineage tumor. Rare unusual plurihormonal tumors feature multi-lineage differentiation. The importance of recognizing multiple synchronous PitNETs is emphasized to avoid misclassification. The term "metastatic PitNET" is advocated to replace the previous terminology "pituitary carcinoma" in order to avoid confusion with neuroendocrine carcinoma (a poorly differentiated epithelial neuroendocrine neoplasm). Subtypes of PitNETs that are associated with a high risk of adverse biology are emphasized within their cell lineage and cell type as well as based on clinical variables. Posterior lobe tumors, the family of pituicyte tumors, include the traditional pituicytoma, the oncocytic form (spindle cell oncocytoma), the granular cell form (granular cell tumor), and the ependymal type (sellar ependymoma). Although these historical terms are entrenched in the literature, they are nonspecific and confusing, such that oncocytic pituicytoma, granular cell pituicytoma, and ependymal pituicytoma are now proposed as more accurate. Tumors with hypothalamic neuronal differentiation are classified as gangliocytomas or neurocytomas based on large and small cell size, respectively. This classification sets the standard for a high degree of sophistication to allow individualized patient management approaches.
Topics: Adenoma; Craniopharyngioma; Humans; Pituitary Gland; Pituitary Neoplasms; World Health Organization
PubMed: 35291028
DOI: 10.1007/s12022-022-09703-7 -
Neuro Endocrinology Letters Nov 2021Pituicytomas (PTs) are rare and benign neoplasms. The variable imaging and clinical features of PTs, which overlap with other sellar pathologies, can make preoperative... (Review)
Review
OBJECTIVE
Pituicytomas (PTs) are rare and benign neoplasms. The variable imaging and clinical features of PTs, which overlap with other sellar pathologies, can make preoperative diagnosis challenging. In the interest of a more comprehensive understanding of the diagnostic aspects of PTs, it is necessary to report and synthesize the variable imaging and clinical features of PTs.
METHODS
We retrospectively included and analysed four pathologically proven PTs with unusual imaging and/or clinical features. Additionally, we reviewed the literature on PT between 2007 and 2019 in the PubMed database to provide context for the individual patient data described herein.
RESULTS
Our series included three female and one male adult patient (mean age: 44.75, age range: 20-56 y). Based on clinical symptoms, we noticed that case 1 had Cushing's syndrome, case 2 had increased prolactin, case 3 had extremity enlargement but with a normal level of human growth factor, and case 4 presented with tinnitus and dizziness. On radiograph, inconsistent with the main imaging findings of PTs in the literature, there was one case in the pituitary anterior lobe, three cases with hypointensity on T2-weighted images, two patients with reduced homogeneous contrast enhancement, and one case demonstrating invasion potential. In addition, one of our patients underwent PET-CT examination, and the lesion had a slight increase in glucose uptake and no significant decrease in ammonia uptake. Postoperative follow-up monitoring revealed no tumour recurrence.
CONCLUSION
Our cases highlight the unusual imaging manifestations of PTs. Recognizing these imaging features plays an important role in the preoperative diagnosis, treatment, and postsurgery monitoring of PTs.
Topics: Adult; Craniopharyngioma; Female; Glioma; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Recurrence, Local; Pituitary Neoplasms; Positron Emission Tomography Computed Tomography; Retrospective Studies; Young Adult
PubMed: 34847317
DOI: No ID Found -
Pituitary Oct 2021Preoperative diagnosis of pituicytomas is difficult, and management and prognostic factors remain ambiguous. The purpose of this study was to elucidate the radiological... (Review)
Review
PURPOSE
Preoperative diagnosis of pituicytomas is difficult, and management and prognostic factors remain ambiguous. The purpose of this study was to elucidate the radiological characteristics of pituicytoma, to assess the risk factors affecting tumor progression, and to propose the optimal treatment regimen based on comprehensive analysis.
METHODS
We reviewed the clinical data of 22 patients with pituicytoma confirmed pathologically in our institution. In addition, 93 cases of pituicytoma in the previous literature were recruited. The individual data of 115 patients were analyzed to evaluate the adverse factors affecting pituicytoma progression.
RESULTS
In the combined cohort, 3 of 61 patients who underwent gross-total resection (GTR) developed recurrence (4.9%); of the 54 patients who received non-GTR, 19 progressed (35.2%). Univariate and multivariate Cox regression analysis verified male gender (HR 2.855, 95% CI 1.008-8.089; p = 0.048), TS (transsphenoidal surgery; HR 3.559, 95% CI 1.015-12.476; p = 0.047), and non-GTR (HR 4.388, 95%CI 1.240-15.521; p = 0.022) were independent unfavorable factors for pituicytoma progression. A multivariate logistic regression model verified that tumor diameter ≥ 1.85 cm (OR 4.859, 95% CI 1.335-17.691; p = 0.016) was independent adverse factors for GTR. Compared with TS, OT (open transcranial) is more likely to have postoperative complications (OR 3.185, 95% CI 1.020-9.944; p = 0.046), especially vision deterioration (OR 37.267, 95% CI 4.486-309.595; p = 0.001).
CONCLUSION
Based on our findings, GTR was advocated as an optimal treatment for pituicytomas. However, in order to avoid damage to important structures, partial resection is acceptable. After that, adjuvant radiotherapy is recommended for male patients with high Ki-67 index, and the remaining patients can be followed up closely. When the tumor recurs or progresses, it is recommended to re-operate and remove the lesion completely as far as possible. If GTR is still not possible, postoperative radiotherapy for the residual tumor is recommended.
Topics: Craniopharyngioma; Glioma; Humans; Male; Pituitary Neoplasms; Prognosis; Retrospective Studies
PubMed: 33982223
DOI: 10.1007/s11102-021-01152-5 -
Neurosurgery Jul 2008Pituicytoma is a rare but distinct low-grade glioma of the neurohypophysis. To date, we have found only 28 cases reported in the literature and have reviewed these in... (Review)
Review
OBJECTIVE
Pituicytoma is a rare but distinct low-grade glioma of the neurohypophysis. To date, we have found only 28 cases reported in the literature and have reviewed these in addition to our own case to delineate the clinical implications of this relatively recently defined tumor.
CLINICAL PRESENTATION
A 71-year-old woman presented with bitemporal hemianopsia and was found to have a large sellar tumor, resembling a pituitary adenoma. Transsphenoidal resection was attempted but was complicated by significant tumor vascularity. Pathology at that time was interpreted as a "granular cell tumor." The patient was then referred to our institution for management of the residual tumor.
INTERVENTION
The patient underwent preoperative embolization to decrease tumor vascularity, and subtotal tumor resection was performed via a craniofacial approach. Postoperatively, the patient has enjoyed significantly improved visual fields despite residual tumor. No adjuvant treatment was given. There has been no regrowth of the residual tumor, as shown on magnetic resonance imaging, over a follow-up period of 1.5 years. The final pathological diagnosis was pituicytoma.
CONCLUSION
Pituicytomas are benign, slow-growing tumors that seem to be cured by gross total resection. The role of radiation therapy is controversial. We advocate an aggressive surgical approach with possible preoperative embolization to reduce the vascularity of the tumor.
Topics: Aged; Female; Glioma; Humans; Pituitary Neoplasms
PubMed: 18728556
DOI: 10.1227/01.NEU.0000335084.93093.C8 -
Acta Endocrinologica (Bucharest,... 2021
PubMed: 34539922
DOI: 10.4183/aeb.2021.137 -
Medicine Mar 2016Pituicytoma is a rare, low-grade glial neoplasm that arises in the neurohypophysis or infundibulum and usually presents as pituitary gland enlargement. They are often... (Review)
Review
Pituicytoma is a rare, low-grade glial neoplasm that arises in the neurohypophysis or infundibulum and usually presents as pituitary gland enlargement. They are often misdiagnosed as pituitary adenomas. Causes have varied for high serum adrenocorticotropic hormone level reported in a few patients with pituicytoma.We report a rare case of pituicytoma accompanied by corticotroph hyperplasia-a challenging diagnosis guided by clinical presentations, radiological signs, and biopsy.We present a case of pituicytoma with corticotroph hyperplasia in a 46-year-old woman with typical Cushing syndrome. Magnetic resonance imaging revealed a lesion in the sellar area with equal T1 and T2 signals and marked homogeneous enhancement. We present detailed analysis of the patient's disease course and review pertinent literature. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal. Because of this, there is no need to conduct special ethic review and the ethical approval is not necessary.The patient underwent a surgical exploration and tumor resection through a trans-sphenoidal approach. Pathologic results revealed pituicytoma and corticotroph hyperplasia. As adrenocorticotropic hormone and cortisol levels did not decrease to normal, the patient received radiotherapy and recovered uneventfully. No recurrence was found over 8 years of follow-up.Pituicytoma is a rare type of sellar tumor. Pituicytomas in patients with Cushing syndrome are rarer still. To our knowledge, this is the first report of Cushing syndrome caused by corticotroph hyperplasia in a pituicytoma patient.
Topics: Corticotrophs; Diagnosis, Differential; Disease Progression; Female; Glioma; Humans; Hyperplasia; Magnetic Resonance Imaging; Middle Aged; Pituitary Neoplasms
PubMed: 26962837
DOI: 10.1097/MD.0000000000003062