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Yasuda ME, Recalde R, Jalón P, Prost D, Golby A, Zaninovich R. Surgical approach to the treatment of pituicytoma. Report of five cases and a literature review. World Neurosurg X 2023; 19:100186. [PMID: 37026087 PMCID: PMC10070180 DOI: 10.1016/j.wnsx.2023.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Background Pituicytoma (PTs) is a rare tumor of the sella and suprasellar region, derived from the pituicytes of the neurohypophysis, having distinct histological characteristics of glial neoplasms. We reported, the clinical data, neuroimaging studies, surgical approaches and pathology in five patients with PTs and also, we reviewed the literature. Methods Retrospective chart from five consecutive patients with PTs treated at one University Hospital from 2016 to 2021 were reviewed. In addition, we conducted a search in PubMed/Medline databases using the term "Pituicytoma". Data regarding age, gender, pathological findings, and treatment modality applied were extracted. Results All patients were female, aged 29-63, complaining of headaches, visual loss and field defects, dizziness and normal or abnormal levels of circulating pituitary hormones. Magnetic Resonance Imaging (MRI) showed in all patients a sellar and suprasellar mass, which was removed through an endoscopic transsphenoidal approach. Our third patient had a subtotal resection followed by close observation. Histopathology showed a glial non-infiltrative tumors with spindle cells, and a final diagnosis of pituicytoma was made. After surgery, visual field defects in all patients were normalized, and in two patients normal levels of plasma hormones were restored. After a mean of three years follow-up, the patients were managed post-operatively through close clinical observation and serial MRI. None of the patients had recurrence of the disease. Conclusion PTs is a rare glial tumor of the sellar and suprasellar region that arises from neurohypophyseal pituicytes. Disease control may be achieved by total excision.
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Affiliation(s)
- Marcos Ezequiel Yasuda
- Department of Neurosurgy, Hospital de Clínicas “José de San Martín”, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
- Corresponding author. Department of Neurosurgery, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina, 2351 Cordoba Ave, Buenos Aires, Buenos Aires, CP: C1120AAF, Argentina.
| | - Rodolfo Recalde
- Department of Neurosurgy, Hospital de Clínicas “José de San Martín”, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Pablo Jalón
- Department of Neurosurgy, Hospital de Clínicas “José de San Martín”, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Diego Prost
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, F-75013, Paris, France
| | - Alexandra Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, United States
- Harvard Medical School, Boston, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Boston, United States
| | - Roberto Zaninovich
- Department of Neurosurgy, Hospital de Clínicas “José de San Martín”, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
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Parish JM, Bonnin JM, Payner TD, Goodman JM, Cohen-Gadol AA. Intrasellar pilocytic astrocytomas: Clinical, imaging, pathological, and surgical findings. J Clin Neurosci 2015; 22:653-8. [DOI: 10.1016/j.jocn.2014.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 10/26/2014] [Indexed: 10/24/2022]
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Schroeder JW, Vezina LG. Pediatric sellar and suprasellar lesions. Pediatr Radiol 2011; 41:287-98; quiz 404-5. [PMID: 21267556 DOI: 10.1007/s00247-010-1968-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 12/06/2010] [Accepted: 12/15/2010] [Indexed: 11/28/2022]
Abstract
Masses arising in the sella turcica and the suprasellar region are common in children. The type and frequency of the various lesions encountered in childhood differ from the adult presentation. This article reviews the embryology of the pituitary gland and its normal appearance in childhood as well as the imaging and clinical findings of the common and some of the uncommon lesions arising in the sella turcica, the pituitary stalk, the suprasellar cistern and the lower third ventricle in the pediatric population.
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Affiliation(s)
- Jason W Schroeder
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, 111 Michigan Ave. NW, Washington, DC 20010, USA
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Czepielewski MA, Rollin GAFS, Casagrande A, Ferreira MP, Ferreira NP. [Nonpituitary tumors of the sellar region]. ARQUIVOS BRASILEIROS DE ENDOCRINOLOGIA E METABOLOGIA 2005; 49:674-90. [PMID: 16444350 DOI: 10.1590/s0004-27302005000500008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The pituitary gland, sella turcica and the parasellar region can be involved by a wide variety of lesions, including benign and malignant neoplasms as well as a wide variety of non neoplastic tumor-like lesions. Clinical and radiological aspects could help in the differential diagnosis of these lesions. Nevertheless, in many cases only the histopathological analysis could establish the definitive diagnosis. In this paper, we review the nonpituitary tumors of the sellar region emphasizing the associated hormonal disturbances.
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Affiliation(s)
- Mauro A Czepielewski
- Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, UFRGS, Porto Alegre, RS.
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Wowra B, Muacevic A, Müller-Schunk S, Tonn JC. Special indications in gamma knife surgery. ACTA NEUROCHIRURGICA. SUPPLEMENT 2004; 91:89-102. [PMID: 15707030 DOI: 10.1007/978-3-7091-0583-2_10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Pilocytic astrocytoma (PA) represent a rare indication for Gamma Knife Surgery. Mostly small remnants after surgical debulking are treated. The prognosis depends on specific variants of biological and clinical criteria. In this regard we differentiated two groups of tumors; the so-called 'typical' tumors with a histological grading of WHO Grade I, no prior fractionated radiotherapy and no cystic component and the so called 'atypical' tumors with either a malignant transformation, previous fractionated radiotherapy and/or cystic components. The outcome after GKS was much more favourable for typical PA than for atypical. In typical cases a high tumor control with a very low risk of side effects can be achieved.
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Affiliation(s)
- B Wowra
- German Gamma Knife Centre Munich, Munich, Germany.
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