Pituicytoma: A case Report

Fatima Obeidat, Khairat Battah, Arwa Battah

Abstract


Pituicytomas are very rare primary tumors of the neurohypophysis and can affect both the sellar and suprasellar regions. According to the 2007 WHO classification of tumors of the central nervous system, pituicytoma is defined as a low-grade spindle cell astrocytic tumor affecting adults, originating in the posterior pituitary or its stalk, presumably arises from pituicytes, a modified specialized glial cells. Only 57 cases reported in the literature so far.

A 50 year old male patient presented with progressive headache that started 2 years ago associated with decreased visual acuity. Radiological studies showed a large enhancing lesion involving the right side of mid skull base. The pituitary gland was not clearly visualized. The patient underwent excision of the mass. Microscopic examination showed proliferation of elongated, bipolar spindle cells arranged in interlacing fascicles, nuclei are of moderate size, with little atypia. Mitotic figures are rare and ki67 was positive in 2-3% of cells. Multiple herring bodies are seen. No evidence of Rosenthal fibers or eosinophilic granular bodies. The differential diagnosis based on the light microscopic appearance included pilocytic astrocytoma, meningioma, schwannoma, solitary fibrous tumor and pituicytoma.
A panel of immunohistochemical stains was performed to identify the nature of the tumor. The tumor cells were positive strongly for GFAP and focally for S-100. EMA and CD34 were negative. The overall picture was consistent with pituicytoma.

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