Surgical management of pituicytomas: a single-center case series

Acta Neurol Belg. 2023 Jun;123(3):815-822. doi: 10.1007/s13760-022-01917-0. Epub 2022 Mar 17.

Abstract

Objective: Pituicytomas (PT) are rare benign sellar and/or supra sellar tumors which surgical treatment might be challenging, owing to the hypervascularity of the tumor. Here, we report our experience with PTs, describe their clinical and radiological features, and propose an optimal therapeutic strategy.

Methods: This is a retrospective single-center study, reporting the clinical manifestations, radiological characteristics, histopathological features, treatment strategies and long-term outcomes of four patients who have been treated for a PT at Bicêtre University Hospital in Paris, France, over the past 7 years.

Results: Four patients were operated mean age at presentation was 60.25 years. Main symptoms, which tended to be progressive, included visual field defects and pituitary-hypothalamic dysfunction. Radiologically, all our cases resented with sellar and suprasellar localization with cavernous invasion in 75% of cases. Endoscopic transphenoidal approach was performed as first surgery for all cases. Transcranial route was done in one case. During surgery, important bleeding was observed in all cases. Gross total resection was obtained with a single surgery in two cases and a second surgery was necessary in the two remaining cases. Pathological diagnosis was confirmed in all cases. No recurrences were noted after an average follow-up of 3.6 years.

Conclusions: PT is a rare differential diagnosis of sellar and/or parasellar tumors, whose hemorrhagic nature can become a challenge during surgery. We added four more cases to the literature to make physicians establish Piticytomas at suspicion diagnosis for sellar and/or suprasellar masses. Knowing the diagnosis, a preparation should be made preoperatively to avoid possible complications peroperatively.

Keywords: Pituicytoma; Pituitary; Spindle cell oncocytoma; Transsphenoidal.

MeSH terms

  • Craniopharyngioma*
  • Diagnosis, Differential
  • Glioma* / diagnosis
  • Humans
  • Middle Aged
  • Pituitary Neoplasms* / diagnostic imaging
  • Pituitary Neoplasms* / surgery
  • Retrospective Studies