Zaki Umaima, Shakeel Areesha Syeda, Rauf Yaseen, Raza Muhammad
Department of Neurosurgery, Patel Hospital, Karachi, Pakistan.
Department of Histopathology, Aga Khan University Hospital, Karachi, Pakistan.
Surg Neurol Int. 2023 Jun 23;14:220. doi: 10.25259/SNI_248_2023. eCollection 2023.
Pituicytomas are rare tumors of the pituitary gland derived from the ependymal cells and line the pituitary stalk and posterior lobe. These tumors are located in the vulnerable regions of the brain: Either in the sellar or suprasellar area. The location marks the difference in the clinical features of the tumor. Here, we report a case of histopathologically diagnosed pituicytoma of the sellar region. Literature is also reviewed and discussed to gain a better understanding of this rare disease.
A 24-year-old female presented to the outpatient department with complaints of headache, diplopia, dizziness, and decreased vision in the right eye for 6 months. Computed tomography scan brain without contrast showed a well-defined hyperdense lesion in the sella without associated bony erosion. Her magnetic resonance imaging showed well defined rounded lesion in the pituitary fossa which was isointense on T1-weighted image and hyperintense on T2-weighted images. A presumptive diagnosis of pituitary adenoma was made. She underwent endoscopic endonasal transsphenoidal resection of pituitary mass. Intraoperatively, normal pituitary gland was visualized and there was a grayish-green-colored, jelly like tumor which was pulled gently. On 9 postoperative day, she presented with cerebrospinal fluid (CSF) rhinorrhea. She underwent endoscopic CSF leak repair. Her histopathology was concluded to be Pituicytoma.
Pituicytoma is an uncommon diagnosis. The surgical aim is to completely excise the tumor which results in complete cure, but incomplete resection may be performed due to high vascularity of this tumor. In case of incomplete excision, recurrence is common and adjuvant radiotherapy may be administered.
垂体细胞瘤是源自室管膜细胞的罕见垂体肿瘤,沿垂体柄和后叶排列。这些肿瘤位于脑部的脆弱区域:蝶鞍内或鞍上区域。该位置标志着肿瘤临床特征的差异。在此,我们报告一例经组织病理学诊断的蝶鞍区垂体细胞瘤病例。还对相关文献进行了综述和讨论,以更好地了解这种罕见疾病。
一名24岁女性因头痛、复视、头晕及右眼视力下降6个月就诊于门诊。脑部计算机断层扫描平扫显示蝶鞍内有一个边界清晰的高密度病变,无相关骨质侵蚀。她的磁共振成像显示垂体窝内有边界清晰的圆形病变,在T1加权图像上呈等信号,在T2加权图像上呈高信号。初步诊断为垂体腺瘤。她接受了经鼻内镜下经蝶窦垂体肿物切除术。术中可见正常垂体,有一个灰绿色、果冻样的肿瘤,被轻轻牵拉。术后第9天,她出现脑脊液鼻漏。她接受了内镜下脑脊液漏修补术。其组织病理学诊断为垂体细胞瘤。
垂体细胞瘤是一种不常见的诊断。手术目标是完全切除肿瘤以实现完全治愈,但由于该肿瘤血管丰富,可能无法完全切除。若切除不完全,复发很常见,可能需要进行辅助放疗。