Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Pituitary
Published in: Pituitary 5/2014

01-10-2014

Surgical management of pituicytomas: case series and comprehensive literature review

Authors: Ming Feng, John D. Carmichael, Vivien Bonert, Serguei Bannykh, Adam N. Mamelak

Published in: Pituitary | Issue 5/2014

Login to get access

Abstract

Objective

Pituicytomas are rare neoplasms that typically present as solid, noninfiltrative tumors occupying the sella and/or suprasellar space for which there is no consensus on optimal surgical management. We aimed to define a preferred surgical strategy for these tumors based on our clinical experience and comprehensive review of the world literature.

Design

Case series and review of the literature.

Methods

We documented the clinical, radiographic, and surgical findings of three patients with pituicytoma treated at our institution, as well as complications and long-term outcomes. A comprehensive review of the medical literature identified all cases of pituicytoma for which data regarding surgical approach, outcome and complications could be extracted. We compared our results with published data.

Results

All three cases at our institution achieved gross total removal. Two patients underwent an expanded endoscopic endonasal transsphenoidal and transplanum (EETS-TP) approach, while one tumor was removed via craniotomy. Post-operatively all patients developed pan-hypopitutarism. The patient undergoing craniotomy suffered profound visual loss but no other neurological complications were noted. A literature review identified 67 reported cases of pituicytoma. Surgical data was available in 60 cases. Surgical approach was documented in 57 patients. Sixty-three surgeries were performed in which approach and extent of resection was available. Gross total removal was obtained in 33 % of craniotomies, 42 % of transsphenoidal procedures, and 100 % of expanded transsphenoidal procedures. Neurological complications including visual loss, hemiparesis and cranial nerve palsies were reported after craniotomy, but not after transsphenoidal approaches. Overall EETS-TP approaches were associated with the highest rate of gross total removal and no visual or neurological complications.

Conclusions

EETS-TP surgery is the preferred strategy for surgical removal of pituicytoma. EETS-TP and transsphenoidal approaches are associated with higher rates of gross total removal and lower rates of neurological complications than craniotomy. Gross total removal should be the intended goal of surgery.
Literature
1.
Chu J, Yang Z, Meng Q, Yang J (2011) Pituicytoma: case report and literature review. Br J Radiol 84:e55–e57CrossRefPubMed
2.
Covington MF, Chin SS, Osborn AG (2011) Pituicytoma, spindle cell oncocytoma, and granular cell tumor: clarification and meta-analysis of the world literature since 1893. AJNR Am J Neuroradiol 32:2067–2072CrossRefPubMed
3.
Grote A, Kovacs A, Clusmann H, Becker AJ, Niehusmann P (2010) Incidental pituicytoma after accidental head trauma—case report and review of literature. Clin Neuropathol 29:127–133CrossRefPubMed
4.
Schmalisch K, Schittenhelm J, Ebner FH, Beuschlein F, Honegger J, Beschorner R (2012) Pituicytoma in a patient with Cushing’s disease: case report and review of the literature. Pituitary 15(Suppl 1):S10–S16CrossRefPubMed
5.
Secci F, Merciadri P, Rossi DC, D’Andrea A, Zona G (2012) Pituicytomas: radiological findings, clinical behavior and surgical management. Acta Neurochir (Wien) 154:649–657, discussion 657
6.
Chakraborti S, Mahadevan A, Govindan A, Sridhar K, Mohan NV, Satish IR, Rudrappa S, Mangshetty S, Shankar SK (2013) Pituicytoma: report of three cases with review of literature. Pathol Res Pract 209:52–58CrossRefPubMed
7.
Uesaka T, Miyazono M, Nishio S, Iwaki T (2002) Astrocytoma of the pituitary gland (pituicytoma): case report. Neuroradiology 44:123–125CrossRefPubMed
8.
Cowan DF, Haubold EM, Tajima Y (2008) Histological, immunohistochemical and pathological features of the pituitary gland of odontocete cetaceans from the Western Gulf of Mexico. J Comp Pathol 139:67–80CrossRefPubMed
9.
Watanabe K (2000) Granular-cell tumor (choristoma, pituicytoma). Ryoikibetsu Shokogun Shirizu 28(Pt 3):218–219
10.
Ellis JA, Tsankova NM, D’Amico R, Ausiello JC, Canoll P, Rosenblum MK, Bruce JN (2012) Epithelioid pituicytoma. World Neurosurg 78(191):E191–E197
11.
Scheithauer BW, Swearingen B, Whyte ET, Auluck PK, Stemmer-Rachamimov AO (2009) Ependymoma of the sella turcica: a variant of pituicytoma. Hum Pathol 40:435–440CrossRefPubMed
12.
Katsuta T, Inoue T, Nakagaki H, Takeshita M, Morimoto K, Iwaki T (2003) Distinctions between pituicytoma and ordinary pilocytic astrocytoma: case report. J Neurosurg 98:404–406CrossRefPubMed
13.
14.
Kanaya H, Kojima K, Katsura S, Hamatsu Y, Tsuchikawa G (1967) Case of pituicytoma. No To Shinkei 19:1015–1020PubMed
15.
Huang Y, Quan J, Su H, Hu HX, Wang F (2012) 40-year old female with a sellar mass. Brain Pathol 22:871–874CrossRefPubMed
16.
Yilmaz O, Turan A, Yigit H, Duymus M, Kosar U (2012) Case of pituicytoma in childhood. Childs Nerv Syst 28:11–12CrossRefPubMed
17.
Furtado SV, Ghosal N, Venkatesh PK, Gupta K, Hegde AS (2010) Diagnostic and clinical implications of pituicytoma. J Clin Neurosci 17:938–943CrossRefPubMed
18.
Hurley TR, D’Angelo CM, Clasen RA, Wilkinson SB, Passavoy RD (1994) Magnetic resonance imaging and pathological analysis of a pituicytoma: case report. Neurosurgery 35:314–317, discussion 317
19.
Ulm AJ, Yachnis AT, Brat DJ, Rhoton Jr AL (2004) Pituicytoma: report of two cases and clues regarding histogenesis. Neurosurgery 54:753–757, discussion 757–758
20.
Gibbs WN, Monuki ES, Linskey ME, Hasso AN (2006) Pituicytoma: diagnostic features on selective carotid angiography and MR imaging. AJNR Am J Neuroradiol 27:1639–1642PubMed
21.
Takei H, Goodman JC, Tanaka S, Bhattacharjee MB, Bahrami A, Powell SZ (2005) Pituicytoma incidentally found at autopsy. Pathol Int 55:745–749CrossRefPubMed
22.
23.
Pirayesh Islamian A, Buslei R, Saeger W, Fahlbusch R (2012) Pituicytoma: overview of treatment strategies and outcome. Pituitary 15:227–236CrossRefPubMed
24.
Liss L, Kahn EA (1958) Pituicytoma, tumor of the sella turcica; a clinicopathological study. J Neurosurg 15:481–488CrossRefPubMed
25.
26.
27.
Zhang F, Chen J, You C (2010) Pituicytoma: case report and review of the literature. Neurol India 58:799–801CrossRefPubMed
28.
Rivero-Celada D, Barrera-Rojas M, Orduna-Martinez J, Lorente-Munoz A, Alfaro-Torres J, Alberdi-Vinas J (2012) Pituitary pituicytoma. Neurocirugia (Astur) 23:165–169CrossRef
29.
Shah B, Lipper MH, Laws ER, Lopes MB, Spellman MJ Jr (2005) Posterior pituitary astrocytoma: a rare tumor of the neurohypophysis: a case report. AJNR Am J Neuroradiol 26:1858–1861PubMed
30.
Ogiwara H, Dubner S, Shafizadeh S, Raizer J, Chandler JP (2011) Spindle cell oncocytoma of the pituitary and pituicytoma: two tumors mimicking pituitary adenoma. Surg Neurol Int 2:116CrossRefPubMedPubMedCentral
31.
Wolfe SQ, Bruce J, Morcos JJ (2008) Pituicytoma: case report. Neurosurgery 63:E173–E174, discussion E174
32.
Schultz AB, Brat DJ, Oyesiku NM, Hunter SB (2001) Intrasellar pituicytoma in a patient with other endocrine neoplasms. Arch Pathol Lab Med 125:527–530PubMed
33.
34.
Nishizawa S, Yokoyama T, Hinokuma K, Ohta S, Uemura K, Takahashi H (1997) Pituitary astrocytoma: magnetic resonance and hormonal characteristics: case illustration. J Neurosurg 87:131CrossRefPubMed
35.
Huynh N, Stemmer-Rachamimov AO, Swearingen B, Cestari DM (2012) Decreased vision and junctional scotoma from pituicytoma: case report. Ophthalmol 3:190–196
36.
Kosuge Y, Hiramoto J, Morishima H, Tanaka Y, Hashimoto T (2012) Neuroimaging characteristics and growth pattern on magnetic resonance imaging in a 52-year-old man presenting with pituicytoma: a case report. J Med Case Rep 6:306CrossRefPubMedPubMedCentral
37.
Cusick JF, Ho KC, Hagen TC, Kun LE (1982) Granular-cell pituicytoma associated with multiple endocrine neoplasia type. J Neurosurg 56:594–596CrossRefPubMed
38.
Newnham HH, Rivera-Woll LM (2008) Images in clinical medicine. Hypogonadism due to pituicytoma in an identical twin. N Engl J Med 359:2824CrossRefPubMed
39.
Hammoud DA, Munter FM, Brat DJ, Pomper MG (2010) Magnetic resonance imaging features of pituicytomas: analysis of 10 cases. J Comput Assist Tomogr 34:757–761CrossRefPubMed
40.
Brat DJ, Scheithauer BW, Staugaitis SM, Holtzman RN, Morgello S, Burger PC (2000) Pituicytoma: a distinctive low-grade glioma of the neurohypophysis. Am J Surg Pathol 24:362–368CrossRefPubMed
41.
Rossi ML, Bevan JS, Esiri MM, Hughes JT, Adams CB (1987) Pituicytoma (pilocytic astrocytoma): case report. J Neurosurg 67:768–772CrossRefPubMed
42.
Benveniste RJ, Purohit D, Byun H (2006) Pituicytoma presenting with spontaneous hemorrhage. Pituitary 9:53–58CrossRefPubMed
43.
Nakasu Y, Nakasu S, Saito A, Horiguchi S, Kameya T (2006) Pituicytoma. Two case reports. Neurol Med Chir (Tokyo) 46:152–156CrossRef
44.
Figarella-Branger D, Dufour H, Fernandez C, Bouvier-Labit C, Grisoli F, Pellissier JF (2002) Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis: report of three cases. Acta Neuropathol 104:313–319PubMed
45.
Brat DJ, Scheithauer BW, Fuller GN, Tihan T (2007) Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. Brain Pathol 17:319–324CrossRefPubMed
46.
Munich SA, Fenstermaker RA, Fabiano AJ, Rigual NR (2013) Cranial base repair with combined vascularized nasal septal flap and autologous tissue graft following expanded endonasal endoscopic neurosurgery. J Neurol Surg A Cent Eur Neurosurg 74(2):101–108
47.
Phillips JJ, Misra A, Feuerstein BG, Kunwar S, Tihan T (2010) Pituicytoma: characterization of a unique neoplasm by histology, immunohistochemistry, ultrastructure, and array-based comparative genomic hybridization. Arch Pathol Lab Med 134:1063–1069PubMedPubMedCentral
48.
Cenacchi G, Giovenali P, Castrioto C, Giangaspero F (2001) Pituicytoma: ultrastructural evidence of a possible origin from folliculo-stellate cells of the adenohypophysis. Ultrastruct Pathol 25:309–312CrossRefPubMed
49.
Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas. World Neurosurg 77:329–341CrossRefPubMed
50.
Elliott RE, Jane Jr JA, Wisoff JH (2011) Surgical management of craniopharyngiomas in children: meta-analysis and comparison of transcranial and transsphenoidal approaches. Neurosurgery 69:630–643, discussion 643
51.
Mascarenhas L, Moshel YA, Bayad F, Szentirmai O, Salek AA, Leng LZ, Hofstetter CP, Placantonakis DG, Tsiouris AJ, Anand VK, Schwartz TH (2013) The transplanum transtuberculum approaches for suprasellar and sellar-suprasellar lesions: avoidance of cerebrospinal fluid leak and lessons learned. World Neurosurg. doi:10.​1016/​j.​wneu.​2013.​02.​032
52.
Barazi SA, Pasquini E, D’Urso PI, Zoli M, Mazzatenta D, Sciarretta V, Frank G (2013) Extended endoscopic transplanum-transtuberculum approach for pituitary adenomas. Br J Neurosurg 27:374–382CrossRefPubMed
Metadata
Title
Surgical management of pituicytomas: case series and comprehensive literature review
Authors
Ming Feng
John D. Carmichael
Vivien Bonert
Serguei Bannykh
Adam N. Mamelak
Publication date
01-10-2014
Publisher
Springer US
Published in
Pituitary / Issue 5/2014
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-013-0515-z

Other articles of this Issue 5/2014

Pituitary 5/2014 Go to the issue

OriginalPaper

Second attempt to withdraw cabergoline in prolactinomas: a pilot study

OriginalPaper

Cerebrovascular complications and utilization of endovascular techniques following transsphenoidal resection of pituitary adenomas: a study of the Nationwide Inpatient Sample 2001–2010

Letter

Reversible pituitary insufficiency due to bexarotene therapy in a patient with mycosis fungoides

OriginalPaper

GH secretion reserve in subclinical hypercortisolism

OriginalPaper

Adult mortality or morbidity is not increased in childhood-onset growth hormone deficient patients who received pediatric GH treatment: an analysis of the Hypopituitary Control and Complications Study (HypoCCS)

OriginalPaper

AZA-Deoxycytidine stimulates proopiomelanocortin gene expression and ACTH secretion in human pituitary ACTH-secreting tumors

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits