Fernando Guerrero-Pérez1, Noemi Vidal2, Agustina Pia Marengo3, Carlos Del Pozo4, Concepción Blanco5, David Rivero-Celada6, Juan José Díez7, Pedro Iglesias7, Antonio Picó8, Carles Villabona3. 1. Department of Endocrinology, Hospital Universitari de Bellvitge, Barcelona, Spain. ferguepe@hotmail.com. 2. Department of Pathology, Hospital Universitari de Bellvitge, Barcelona, Spain. 3. Department of Endocrinology, Hospital Universitari de Bellvitge, Barcelona, Spain. 4. Department of Endocrinology, Hospital Universitari Mutua Terrassa, Barcelona, Spain. 5. Department of Endocrinology, Hospital Universitario Príncipe de Asturias, Madrid, Spain. 6. Department of Neurosurgery, Hospital Universitario Miguel Servet, Zaragoza, Spain. 7. Department of Endocrinology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 8. Department of Endocrinology, Hospital General Universitario de Alicante, Alicante, Spain.
Abstract
PURPOSE: In 2017, the WHO established that pituicytoma, granular cell tumour (GCT) and spindle cell oncocytoma (SCO) are posterior pituitary tumours (PPT). Recent data suggests that these tumours probably arise from the pituicytes and may constitute a spectrum of a unique histopathological entity. Our aim is to report the clinical findings and surgical outcomes of 16 patients with PPT. We also evaluated the tissue specimens available in light of current knowledge. METHOD: Cross-sectional study with retrospective data. RESULTS: PPT were 7 pituicytomas, 3 GCT and 6 SCO. Patients mean age was 55 years old and 75% were female. Basal hormonal study showed hyperprolactinemia (43.7%) and hypopituitarism (37.5%). There was no case of diabetes insipidus (DI). MRI showed sellar/suprasellar masses with mean size of 19.7mm. PPT was not suspected in any patient. Fifteen patients underwent surgery and complications were common: 20% had perioperative bleeding (one patient died because of a massive haemorrhage), 57.1% hypopituitarism, 35.7% permanent DI and 21.4% underwent a second surgery. Pathological findings shown positivity for thyroid transcription factor 1, vimentin and negativity for cytokeratin and chromogranin A in all specimens evaluated. S100 protein was positive in 88.8% of tumours. Ki67 was ≥ 3% in 66.6% and ranged from 4-7% in SCO. CONCLUSION: PPT have similar histology, clinical features and are frequently misdiagnosed as nonfunctioning pituitary tumours. However, post-surgical complications including haemorrhage are common. A high clinical suspicion is needed to presume the diagnosis prior surgery and diminish the high morbidity of these tumours.
PURPOSE: In 2017, the WHO established that pituicytoma, granular cell tumour (GCT) and spindle cell oncocytoma (SCO) are posterior pituitary tumours (PPT). Recent data suggests that these tumours probably arise from the pituicytes and may constitute a spectrum of a unique histopathological entity. Our aim is to report the clinical findings and surgical outcomes of 16 patients with PPT. We also evaluated the tissue specimens available in light of current knowledge. METHOD: Cross-sectional study with retrospective data. RESULTS:PPT were 7 pituicytomas, 3 GCT and 6 SCO. Patients mean age was 55 years old and 75% were female. Basal hormonal study showed hyperprolactinemia (43.7%) and hypopituitarism (37.5%). There was no case of diabetes insipidus (DI). MRI showed sellar/suprasellar masses with mean size of 19.7mm. PPT was not suspected in any patient. Fifteen patients underwent surgery and complications were common: 20% had perioperative bleeding (one patient died because of a massive haemorrhage), 57.1% hypopituitarism, 35.7% permanent DI and 21.4% underwent a second surgery. Pathological findings shown positivity for thyroid transcription factor 1, vimentin and negativity for cytokeratin and chromogranin A in all specimens evaluated. S100 protein was positive in 88.8% of tumours. Ki67 was ≥ 3% in 66.6% and ranged from 4-7% in SCO. CONCLUSION:PPT have similar histology, clinical features and are frequently misdiagnosed as nonfunctioning pituitary tumours. However, post-surgical complications including haemorrhage are common. A high clinical suspicion is needed to presume the diagnosis prior surgery and diminish the high morbidity of these tumours.
Entities:
Keywords:
Granular cell tumours of the neurohypophysis; Pituicytoma; Posterior pituitary tumours; Spindle cell oncocytoma
Authors: Abdul-Kareem Ahmed; Hassan Y Dawood; David J Cote; Tejus A Bale; Umberto De Girolami; Edward R Laws; Timothy R Smith Journal: Pituitary Date: 2019-12 Impact factor: 4.107
Authors: Lilla Krokker; Gábor Nyírő; Lilla Reiniger; Ottó Darvasi; Nikolette Szücs; Sándor Czirják; Miklós Tóth; Péter Igaz; Attila Patócs; Henriett Butz Journal: Neurochem Res Date: 2019-04-03 Impact factor: 3.996