Li Jing, Chen Shuaiming, Tan Huiwen, Yu Yerong, Tang Ying, Cai Bowen, Li Jianwei
Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.
Department of Pathology, West China Hospital of Sichuan University, Chengdu, China.
Front Endocrinol (Lausanne). 2025 Mar 18;16:1487120. doi: 10.3389/fendo.2025.1487120. eCollection 2025.
Posterior pituitary tumors (PPTs) are extremely rare, with fewer than 400 cases reported to date. In 2022, the World Health Organization (WHO) classified four types of tumors originating from the posterior pituitary: traditional pituicytoma, oncocytic pituicytoma, granular pituicytoma, and ependymal pituicytoma. To our knowledge, only one subject with coexistence of Cushing's disease and oncocytic pituicytoma (spindle cell oncocytoma) has been reported, but the clinical features of this patient were not described in detail.
We presented a case of a patient with Cushing's syndrome and a pituitary mass. Transsphenoidal surgery was performed, and pathologic examination revealed two distinct tumors: a corticotroph adenoma with a diameter of less than 2 mm and a larger oncocytic pituicytoma. Post-surgery serum cortisol was 51 nmol/L, indicating complete remission. Corticotroph adenoma or corticotroph hyperplasia was identified after surgery in less than half of the subjects with Cushing's disease and PPT.
Our study indicates that Cushing's disease in patients with PPT may be caused by the existence of collision lesions, with corticotroph adenoma or hyperplasia being difficult to detect due to their small dimensions.
垂体后叶肿瘤（PPTs）极为罕见，迄今为止报告的病例不足400例。2022年，世界卫生组织（WHO）将起源于垂体后叶的肿瘤分为四种类型：传统垂体细胞瘤、嗜酸性垂体细胞瘤、颗粒性垂体细胞瘤和室管膜性垂体细胞瘤。据我们所知，仅有1例库欣病与嗜酸性垂体细胞瘤（梭形细胞嗜酸性细胞瘤）共存的病例报道，但该患者的临床特征未详细描述。
我们报告了1例患有库欣综合征和垂体肿块的患者。进行了经蝶窦手术，病理检查发现两种不同的肿瘤：直径小于2毫米的促肾上腺皮质激素腺瘤和较大的嗜酸性垂体细胞瘤。术后血清皮质醇为51 nmol/L，表明完全缓解。在患有库欣病和PPT的患者中，术后不到一半的患者被确诊为促肾上腺皮质激素腺瘤或促肾上腺皮质激素增生。
我们的研究表明，PPT患者的库欣病可能由碰撞性病变引起，由于促肾上腺皮质激素腺瘤或增生体积较小，难以检测到。
