Ulm Arthur J, Yachnis Anthony T, Brat Daniel J, Rhoton Albert L
Department of Neurological Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA.
Neurosurgery. 2004 Mar;54(3):753-7; discussion 757-8. doi: 10.1227/01.neu.0000108983.50966.b7.
The pituicytoma is a rare primary tumor of the neurohypophysis. Although histologically benign, the location and vascular nature of these tumors can make surgical resection difficult. We present a report of two patients with pituicytomas and review the literature regarding treatment and prognosis for this unusual lesion. Possible histogenetic relationships of this tumor with other pituitary neoplasms are presented.
Patient 1 was a 45-year-old man who presented with a 5-year history of decreased libido. He was found to have a 2-cm suprasellar mass on a magnetic resonance imaging scan. Patient 2 was a 48-year-old man who presented with multiple endocrine complaints. He was found to have an intrasellar mass on magnetic resonance imaging.
Patient 1 underwent a right frontal craniotomy, with a subtotal resection of the suprasellar mass through the lamina terminalis. The residual tumor was treated with fractionated stereotactic radiotherapy. The intrasellar mass in Patient 2 was resected via a transsphenoidal approach. On surveillance magnetic resonance imaging, the tumor was found to have recurred and expanded into the suprasellar space. The patient underwent a right frontal craniotomy for decompression and a subtotal resection of the tumor. The patient experienced a second recurrence 7 years after the initial procedure and was subsequently treated with fractionated stereotactic radiotherapy.
Pituicytomas are a distinct form of pituitary gland neoplasia that may recur if subtotally resected. These neurohypophysial tumors may contain a small subpopulation of previously unrecognized bcl-2-immunoreactive cells, whose role in the histogenesis of pituicytoma deserves further study.
垂体细胞瘤是一种罕见的神经垂体原发性肿瘤。尽管在组织学上为良性，但这些肿瘤的位置和血管特性可能使手术切除困难。我们报告两例垂体细胞瘤患者，并回顾关于这种不寻常病变的治疗和预后的文献。还介绍了该肿瘤与其他垂体肿瘤可能的组织发生关系。
患者1是一名45岁男性，有5年性欲减退病史。磁共振成像扫描发现其鞍上有一个2厘米的肿块。患者2是一名48岁男性，有多种内分泌方面的主诉。磁共振成像发现其鞍内有一个肿块。
患者1接受了右额开颅手术，通过终板对鞍上肿块进行了次全切除。残留肿瘤接受了分次立体定向放射治疗。患者2的鞍内肿块通过经蝶窦入路切除。在随访磁共振成像中，发现肿瘤复发并扩展至鞍上间隙。该患者接受了右额开颅减压及肿瘤次全切除手术。患者在初次手术后7年出现第二次复发，随后接受了分次立体定向放射治疗。
垂体细胞瘤是垂体肿瘤的一种独特形式，如果次全切除可能会复发。这些神经垂体肿瘤可能含有一小部分以前未被识别的bcl-2免疫反应性细胞，其在垂体细胞瘤组织发生中的作用值得进一步研究。
