Cossu Giulia, Dimitriou Julien, Brouland Jean-Philippe, Daniel Roy Thomas, Messerer Mahmoud
Department of Neurosurgery, University Hospital of Lausanne, 1011 Lausanne, Switzerland.
Department of Clinical Pathology, University Hospital of Lausanne, 1011 Lausanne, Switzerland.
Oncol Lett. 2018 Jul;16(1):643-647. doi: 10.3892/ol.2018.8625. Epub 2018 May 3.
Pituicytomas are a rare form of indolent neoplasms, which typically present with visual disturbance and hypopituitarism. Complete resection by a trans-sphenoidal approach is the optimal treatment. Only 80 cases have been described thus far in the current literature and the present case is the first to describe the development of pituitary apoplexy in the context of a pituicytoma. A 77-year-old man presented with fatigue and clinical signs of hypogonadism and a sellar lesion was diagnosed at cerebral magnetic resonance imaging (MRI). A watch-and-wait management was initially decided and 1 year after the initial diagnosis, he presented with a thunderclap headache with images suggestive of pituitary apoplexy. A pituitary adenoma was suspected and an endoscopic resection was decided upon the development of a visual deficit. Pathological analysis established the correct diagnosis of a pituicytoma. Pituicytomas are characterised by dense vascularisation, thus ischaemic and haemorrhagic events may be common. When confronted with a hypervascularised pituitary lesion demonstrating strong contrast enhancement and no abnormal hormonal secretion, one must maintain a high index of suspicion for a pituicytoma. A wide range of differential diagnoses should thus be considered in the context of pituitary apoplexy.
垂体细胞瘤是一种罕见的惰性肿瘤，通常表现为视力障碍和垂体功能减退。经蝶窦入路完全切除是最佳治疗方法。目前文献中迄今仅描述了80例病例，本病例是首例描述垂体细胞瘤背景下垂体卒中发生情况的病例。一名77岁男性因疲劳和性腺功能减退的临床体征就诊，脑部磁共振成像（MRI）诊断为鞍区病变。最初决定采取观察等待的处理方式，初次诊断1年后，他出现霹雳样头痛，影像学检查提示垂体卒中。怀疑为垂体腺瘤，在出现视力缺损后决定进行内镜切除。病理分析确诊为垂体细胞瘤。垂体细胞瘤的特点是血管密集，因此缺血和出血事件可能很常见。当面对一个血管高度丰富、增强造影强烈且无异常激素分泌的垂体病变时，必须高度怀疑垂体细胞瘤。因此，在垂体卒中的情况下应考虑广泛的鉴别诊断。
