Clinical diagnosis and treatment strategies of pituicytomas / 医学研究生学报

Objective Reports are rarely seen on the clinical studies of pituicytomas. This article discusses the clinical diagnosis, treatment strategies, pathological features and postoperative complications of pituicytomas. Methods This retrospective study included 10 cases of pituicytomas treated in our hospital from July 2008 to July 2018. All the patients underwent microsurgery, gross total resection of the tumor in 6 cases and subtotal resection in the other 4. We analyzed the histopathological features, postoperative complications and follow-up data of the patients. Results The tumors were tightly organized morphologically, consisting of bipolar spindle-shaped cells, arranged like crosswise-woven fiber bundles or in a storiform pattern, the cytoplasm stained red and eosinophilic, the nuclei medium-sized, round, oval or spindle shaped, mildly heterotypical, with visible microencapsulation and abundant interstitial blood vessels. The main postoperative complications included insipidus in 8 cases, hyponatremia in 4, decreased visual acuity in 3, hypopituitarism in 2, and intracranial infection in 1. Of the 9 patients followed up, 1 experienced recurrence at 2 years postoperatively and received another surgery, with no more recurrence hitherto. Conclusion Definite diagnosis of pituicytoma depends on pathological examination, and adequate attention should be paid to the prevention and management of such postoperative complications as insipidus and hyponatremia.

Recurrent Pituicytoma in a Pediatric Patient: A Case Report

Pituicytoma is a rare tumor that arises from the glial cells of the neurohypophysis. For a long time, it was believed that pituicytomas only appeared in adults. Currently, at least three cases of this entity occurring in children have been reported in the literature. The aim of the present report is to describe the case of a 5-year-old girl who presented to the emergency department with visual disturbances, and the diagnosis was a recurrent pituicytoma. Therefore, the clinical presentation, the radiological features of the tumor, and the corresponding surgical management are described. Additionally, a brief review of the management of this unusual entity was performed.

O pituicitoma é um tumor raro que surge das células gliais da neurohipófise. Durante muito tempo, acreditou-se que os pituicitomas só aparecessem em adultos. Atualmente, pelo menos três casos desta entidade ocorrendo em crianças foram relatados na literatura. O objetivo do presente artigo é descrever o caso de uma menina de 5 anos que chegou à emergência com distúrbios visuais, e o diagnóstico foi um pituicitoma recorrente. A apresentação clínica, as características radiológicas do tumor, e o correspondente manejo cirúrgico foram, portanto, descritos. Além disso, foi realizada uma breve revisão do tratamento desta entidade incomum.

Clinicopathological study of pituicytoma and its rare ependymal variant / 临床与实验病理学杂志

Purpose To study the clinicopathological, immunophynotypic features of pituicytoma and its rare ependymal variant with discussion of its diagnosis and differential diagnosis. Methods 7 cases of pituicytoma, including 6 conventional pituicytomas and 1 ependymal variant tumor, were evaluated by HE staining and immunohistochemistry, and the relevant literatures were reviewed. Results Microscopically, the tumors were composed of closely packed plump spindle cells arranged in short fascicle and storiform pattern in 6 conventional pituicytomas, and whorl and papillary architecture with obvious perivascular rosette formation in the ependymal variant tumor. Immunohistochemically, all tumor cells were diffuse positive for S-100 and TTF-1, but negative for IDH1 R132H, Olig-2, CD34, NF, Syn, CgA, and pituitary hormones. Ki-67 proliferation index was less than 2％ in all cases. GFAP and EMA were only focally positive in conventional pituicytomas, whereas GFAP was diffuse positive in ependymal variant tumor with EMA dot-like staining in more than half of tumor cells. Conclusion Pituicytoma is a rare low grade glioma derived from neurohypophysis. To study helps recognition of extending morphological spectrum of pituicytoma and its new variant, which is important for its differential diagnosis consideration and clinical therapy.

Pituicytoma with Significant Tumor Vascularity Mimicking Pituitary Macroadenoma

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.

Pituicytoma in the sellar region:a clinicopathological analysis of 10 cases / 临床与实验病理学杂志

Purpose To study the c1inica1 and patho1ogica1 features of pituicytoma. Methods Ten cases of pituicytoma were re-trieved. Their c1inicopatho1ogic and immunohistochemica1 features were studied,and the re1ated 1iterature was a1so reviewed. Results The 10 patients aged from 4 to 68 years,with 4 ma1es,and 6 fema1es. The fo11ow-up information of 9 cases was co11ected:a11 of them were survived,whi1e one fema1e recurred 2 years after operation. Histo1ogica11y,the tumor was composed of bipo1ar e1ongated spind1e ce11. Immunohistochemica11y,the tumor ce11s showed strong1y positive for S-100(10/10)and vimentin(10/10),whi1e weak or foca1 positive for GFAP(10/10)and EMA(4/10). CKpan was negative in a11 cases and Ki-67 pro1iferation index was 1ow(1% ~5%). Conclusion Pituicytoma is a 1ow-grade spind1e ce11 tumor,typica11y occurs in the se11ar region. It is most common1y found in adu1ts,especia11y in ado1escent patients. The tumor shou1d be distinguished from pi1ocytic astrocytoma and neurohypophysea1granu1ar ce11 tumor. Pituicytoma exhibits strong1y positive for S-100 and vimentin. Genera11y,this tumor behaves indo1ent1y,but some may re-cur.

Pituicytoma: Case Report

We report a case of Pituicytoma, which is a rare brain tumor occuring in the sellar region. A 44-year-old woman presented with polyuria, polydipsia, visual disturbance, amenorrhea and galactorrhea 1 year prior to admission. A magnetic resonance image revealed a well enhancing pituitary mass with large suprasellar extension. There was no area of normal hyperintensity showing the posterior lobe of the pituitary gland. The tumor was subtotally removed via transsphenoidal surgery. Pathological examination of the surgical specimen showed astrocytes with spindle-shaped fibrillary cytoplams. Immunohistochemical staining was positive for glial fibrillary acidic protein, S-100, vimentin. Radiotherapy was not given after surgery.