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Case Reports
. 2017 Jan;96(4):e5657.
doi: 10.1097/MD.0000000000005657.

Malignant adenohypophysis spindle cell oncocytoma with repeating recurrences and a high Ki-67 index

Xiangyi Kong  1 , Dongmei Li, Yanguo Kong, Dingrong Zhong
Affiliations
Free PMC article
Case Reports

Malignant adenohypophysis spindle cell oncocytoma with repeating recurrences and a high Ki-67 index

Xiangyi Kong et al. Medicine (Baltimore). 2017 Jan.
Free PMC article

Abstract

Adenohypophysis spindle cell oncocytoma (ASCO) is a rare tumor recently reported by Roncaroli et al in 2002. This tumor is considered a grade I tumor by the World Health Organization.We report a rare case of malignant ASCO with repeating recurrences and a high Ki-67 index-a challenging diagnosis guided by clinical presentations, radiological signs, and postoperative pathological tests.We represent a 30-year-old man who had suffered from headaches, diplopia, and impaired visual field and acuity. His magnetic resonance imaging revealed an abnormal sellar mass and was originally misdiagnosed as a pituitary macroadenoma. We present detailed analysis of the patient's disease course and review relevant literature.When surgically treated, the specimen revealed a typical histopathology pattern of ASCO. The tumor recurred for several times and the patient underwent 3 surgeries and 1 γ-knife treatment, which was accompanied by a continuously increasing Ki-67 index.This is the first reported case of malignant ASCO (WHO III-IV grade). Despite its rarity, ASCO should be considered in the differential diagnosis of sellar lesions that mimic pituitary adenomas.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
MRI for the abnormalities in the sellar region at different time points. A–C, Before the first surgery. A, Coronal-enhanced T1WI. B, Axial-enhanced T1WI. C, Sagittal-enhanced T1WI. D–E, Before γ-knife treatment. D, Coronal-enhanced T1WI. E, Axial T1WI. F–H, Before the secondary surgery. F, Coronal-enhanced T1WI. G, Axial T1WI. H, Sagittal-enhanced T1WI. I–K, After the secondary surgery. I, Coronal-enhanced T1WI. J, Axial-enhanced T1WI. K, Sagittal-enhanced T1WI. L–P, Before the third surgery. L, Coronal T1WI. M, Coronal-enhanced T1WI. N, Coronal T2WI. O, Sagittal T1WI. P, Sagittal-enhanced T1WI. MRI = magnetic resonance imaging.
Figure 2
Figure 2
Histopathological and immunohistochemical examination images for the surgical specimen. A–K, Specimen after the first surgery. A, H & E, ×10. B, H & E, ×20. C, AE-1/AE-3, ×10. D, AS-1, ×10. E, CD34, ×10. F, CD68, ×10. G, Desmin, ×10. H, S-100 protein, ×10. I, SMA, ×10. J, SMA, ×20. K, Vimentin, ×10. L, Specimen after the third surgery, Ki-67 proliferation index 45%, ×10. H & E = hematoxylin and eosin, SMA = smooth muscle actin.
Figure 3
Figure 3
A timeline of the publications related to ASCO. ASCO = adenohypophysis spindle cell oncocytoma.
Figure 4
Figure 4
A world map with the global distribution of ASCO-related publications based on the analysis of their geolocational data. ASCO = adenohypophysis spindle cell oncocytoma.
Figure 5
Figure 5
Oncocytoma-related genes by virtue of searching database via Phenolyzer.
See this image and copyright information in PMC

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References

    1. Fuller GN, Scheithauer BW. The 2007 Revised World Health Organization (WHO) Classification of Tumours of the Central Nervous System: newly codified entities. Brain Pathol 2007;17:304–7. - PubMed
    1. Roncaroli F, Scheithauer BW, Cenacchi G, et al. ‘Spindle cell oncocytoma’ of the adenohypophysis—a tumor of folliculostellate cells? Am J Surg Pathol 2002;26:1048–55. - PubMed
    1. Romero-Rojas AE, Melo-Uribe MA, Barajas-Solano PA, et al. Spindle cell oncocytoma of the adenohypophysis. Brain Tumor Pathol 2011;28:359–64. - PubMed
    1. Rotman JA, Kucharczyk W, Zadeh G, et al. Spindle cell oncocytoma of the adenohypophysis: a case report illustrating its natural history with 8-year observation and a review of the literature. Clin Imaging 2014;38:499–504. - PubMed
    1. Vuong HG, Kondo T, Tran TM, et al. Spindle cell oncocytoma of adenohypophysis: report of a case and immunohistochemical review of literature. Pathol Res Pract 2016;212:222–5. - PubMed

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