Neurosurgery Department, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France.
Neurosurgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia.
Acta Neurol Belg. 2023 Jun;123(3):815-822. doi: 10.1007/s13760-022-01917-0. Epub 2022 Mar 17.
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.
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.
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.
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.
垂体细胞瘤（PT）是罕见的良性鞍内和/或鞍上肿瘤，由于肿瘤的高度血管化，手术治疗可能具有挑战性。在这里，我们报告我们的经验与 PT，描述其临床和影像学特征，并提出一个最佳的治疗策略。
这是一个回顾性的单中心研究，报告了过去 7 年来在法国巴黎比塞特尔大学医院接受治疗的 4 例 PT 患者的临床表现、影像学特征、组织病理学特征、治疗策略和长期结果。
4 例患者的平均年龄为 60.25 岁。主要症状为进行性视力障碍和垂体下丘脑功能障碍。影像学上，我们所有的病例均表现为鞍内和鞍上占位，75%的病例伴有海绵窦侵犯。所有病例均采用经蝶窦内镜入路作为首次手术。1 例采用经颅途径。术中均可见大量出血。2 例患者单次手术获得大体全切除，其余 2 例患者需行二次手术。所有病例均得到病理证实。平均随访 3.6 年后无复发。
PT 是鞍内和/或鞍旁肿瘤的罕见鉴别诊断，其出血性质可能成为手术中的挑战。我们在文献中增加了 4 个病例，使医生对鞍内和/或鞍旁肿块的诊断更为警惕。一旦确诊，应在术前做好准备，以避免术中可能出现的并发症。
