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01-01-2019 | Endocrine Surgery

Posterior pituitary tumours: the spectrum of a unique entity. A clinical and histological study of a large case series

Authors: Fernando Guerrero-Pérez, Noemi Vidal, Agustina Pia Marengo, Carlos Del Pozo, Concepción Blanco, David Rivero-Celada, Juan José Díez, Pedro Iglesias, Antonio Picó, Carles Villabona

Published in: Endocrine | Issue 1/2019

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.

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Title: Posterior pituitary tumours: the spectrum of a unique entity. A clinical and histological study of a large case series
Authors: Fernando Guerrero-Pérez
Noemi Vidal
Agustina Pia Marengo
Carlos Del Pozo
Concepción Blanco
David Rivero-Celada
Juan José Díez
Pedro Iglesias
Antonio Picó
Carles Villabona
Publication date: 01-01-2019
Publisher: Springer US
Published in: Endocrine / Issue 1/2019
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-018-1774-2

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