Kremenevski Natalia, Schnell Oliver, Coras Roland, Buchfelder Michael, Hore Nirjhar
Department of Neurosurgery, Friedrich-Alexander Universität Erlangen-Nuremberg, Erlangen, Germany.
Department of Neuropathology, Friedrich-Alexander Universität Erlangen-Nuremberg, Erlangen, Germany.
Pituitary. 2025 Apr 5;28(2):45. doi: 10.1007/s11102-025-01518-z.
This study evaluates the clinical presentation, endocrine dysfunction, surgical outcome, and long-term prognosis in patients with histologically confirmed posterior pituitary tumors (PPTs).
A retrospective cohort study was conducted on 19 patients treated for PPTs at a single center between 2000 and 2023. Data on clinical, endocrine, and surgical outcomes were collected and analyzed.
The cohort included 3 pituicytomas (PCs), 8 granular cell tumors (GCTs), and 8 spindle cell oncocytomas (SCOs) patients, with a female predominance (58%) and a mean age of 57.2 ± 13.2 years. Symptoms leading to diagnosis were headache (31.6%), visual impairment (21%), and sexual dysfunction (10.5%). GCT patients had higher preoperative BMI (34.49 ± 5.72) compared to PC (22.12 ± 2.40) and SCO (24.74 ± 4.24) patients (p < 0.01). Postoperative BMI increased across all groups, with GCTs patients showing the steepest rise (p < 0.01). Endocrine dysfunction largely persisted or worsened after surgery, with limited recovery at follow-up. Surgical approaches included transsphenoidal (48%) and transcranial (52%), achieving gross total resection in 58% of cases. Tumor recurrence occurred in 16% of patients, all requiring adjuvant radiation therapy. Tumor-specific survival at 5 years was 100% with an overall survival rate of 80% where non-tumor-related comorbidities accounted for the observed mortality.
PPTs are rare tumors with significant endocrine and metabolic consequences. While surgical management is associated with favorable tumor-specific survival, persistent endocrine dysfunction and postoperative progressive BMI underscore the need for long-term follow-up and targeted interventions. These findings contribute to the understanding of PPT biology and support the development of optimized management strategies.
本研究评估经组织学确诊的垂体后叶肿瘤（PPTs）患者的临床表现、内分泌功能障碍、手术结果及长期预后。
对2000年至2023年间在单一中心接受PPTs治疗的19例患者进行回顾性队列研究。收集并分析临床、内分泌及手术结果数据。
该队列包括3例垂体细胞瘤（PCs）、8例颗粒细胞瘤（GCTs）和8例梭形细胞嗜酸细胞瘤（SCOs）患者，女性占多数（58%），平均年龄为57.2±13.2岁。导致诊断的症状包括头痛（31.6%）、视力障碍（21%）和性功能障碍（10.5%）。与PC患者（22.12±2.40）和SCO患者（24.74±4.24）相比，GCT患者术前BMI更高（34.49±5.72）（p<0.01）。所有组术后BMI均升高，其中GCT患者升高最为显著（p<0.01）。内分泌功能障碍在术后大多持续存在或恶化，随访时恢复有限。手术入路包括经蝶窦（48%）和经颅（52%），58%的病例实现了全切除。16%的患者出现肿瘤复发，均需要辅助放疗。5年肿瘤特异性生存率为100%，总生存率为80%，非肿瘤相关合并症是观察到的死亡原因。
PPTs是罕见肿瘤，具有显著的内分泌和代谢后果。虽然手术治疗与良好的肿瘤特异性生存率相关，但持续的内分泌功能障碍和术后BMI进行性增加强调了长期随访和针对性干预的必要性。这些发现有助于理解PPT生物学特性，并支持优化管理策略的制定。
