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Review
. 2012 Jul;78(1-2):191.E1-7.
doi: 10.1016/j.wneu.2011.09.011. Epub 2011 Nov 7.

Epithelioid pituicytoma

Jason A Ellis  1 , Nadejda M Tsankova, Randy D'Amico, John C Ausiello, Peter Canoll, Marc K Rosenblum, Jeffrey N Bruce
Affiliations
Review

Epithelioid pituicytoma

Jason A Ellis et al. World Neurosurg. 2012 Jul.

Abstract

Background: Pituicytomas are rare tumors of the sellar region that are derived from specialized glial cells called pituicytes. They characteristically exhibit spindle-cell features and fascicular or storiform patterns of growth. No other histological variants of this tumor have been described.

Case description: Here we report a diagnostically challenging case of pituicytoma in a 42-year-old man with a sellar mass arising from the pituitary stalk. On histological examination, the tumor displayed an epithelioid histoarchitecture with no characteristic spindle-cell or fascicular growth features. Strong immunopositivity for the pituicyte marker thyroid transcription factor-1 within tumor cells proved essential for diagnosing this unusual pituicytoma variant.

Conclusion: Pituicytomas may display epithelioid rather than fascicular or storiform histoarchitecture. Epithelioid pituicytoma variants may be diagnosed in cases such as ours in which both the clinical findings and immunohistochemical analysis suggest a tumor derived from pituicytes.

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Figures

Figure 1
Figure 1. Preoperative brain imaging
Contrast MR in axial (A), sagittal (B), and coronal (C) views show a homogenously enhancing suprasellar lesion with mass effect within the inferior third ventricle.
Figure 2
Figure 2. Intraoperative diagnosis
Squash preparation of fresh tissue during intraoperative consultation shows loosely-cohesive clusters of cells with occasional small cytoplasmic processes (400X).
Figure 3
Figure 3. Histological features
Hematoxylin and eosin (H&E) stained sections at low (A, 100X) and high (B, 400X) power magnification shows a hypercellular neoplasm with vague trabecular architecture and epithelioid morphology. Tumor cells have plump ovoid or irregular vesiculated nuclei, distinct nucleoli, and pale eosinophilic cytoplasm with occasional vacuolation.
Figure 4
Figure 4. Immunohistochemical analysis
Focal, strong immunopositivity for GFAP (A), cytoplasmic immunopositivity for S-100 (B), and widespread nuclear immunopositivity for TTF-1 (C) is evident within the tumor (100X). Ki-67 immunoreactivity (D, 40X) is demonstrated in 4% of cells on average and in up to 8% of cells focally (inset, lower right, 100X)).
Figure 5
Figure 5. Postoperative brain imaging
Contrast MR in axial (A), sagittal (B), and coronal (C) views show no evidence of tumor recurrence 3 months postoperatively.
See this image and copyright information in PMC

Comment in

  • Pituicytomas, a perspective.
    Ciric I. Ciric I. World Neurosurg. 2012 Jul;78(1-2):84. doi: 10.1016/j.wneu.2011.11.011. Epub 2011 Nov 23. World Neurosurg. 2012. PMID: 22381328 No abstract available.

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