Pituicytoma: Report of two cases

Abstract

This report describes two cases of pituicytoma. The two patients were female and presented with visual complaints, diabetes insipidus, headaches and menstrual disorders. The imaging characteristic was an intrasellar or suprasellar mass, and one mass originated in the pituitary stalk. The mass showed homogeneous enhancement with contrast administration. A hematoxylin and eosin stain showed a compact structure consisting of elongated, bipolar spindle cells arranged in interlacing fascicles or assuming a storiform pattern. Immunohistochemically, the tumor showed diffuse strong expression of S-100 protein, vimentin and epithelial membrane antigen, and glial fibrillary acidic protein was focally positive. The pituicytoma may have originated in the pituitary stalk and presented with diabetes insipidus, and the differential diagnosis should be compared with the pituitary stalk mass. Bleeding during resection was moderate, and surgery was regarded as the first choice of treatment for pituicytomas.

Figure 1

(a and b) T1W1-weighted coronal and sagittal MRI scans showing the intersellar mass. (c and d) T1-weighted contrast-enhanced coronal and sagittal MRI scans for the same patient showed no regrowth or residual mass 18 months post-operatively.

Figure 1

(a and b) T1W1-weighted coronal and sagittal MRI scans showing the intersellar mass. (c and d) T1-weighted contrast-enhanced coronal and sagittal MRI scans for the same patient showed no regrowth or residual mass 18 months post-operatively.

Figure 1

(a and b) T1W1-weighted coronal and sagittal MRI scans showing the intersellar mass. (c and d) T1-weighted contrast-enhanced coronal and sagittal MRI scans for the same patient showed no regrowth or residual mass 18 months post-operatively.

Figure 1

(a and b) T1W1-weighted coronal and sagittal MRI scans showing the intersellar mass. (c and d) T1-weighted contrast-enhanced coronal and sagittal MRI scans for the same patient showed no regrowth or residual mass 18 months post-operatively.

Figure 2

(a and b) T1W1-weighted contrast-enhanced sagittal and coronal MRI scans showing the heterogeneous enhancement of the suprasellar mass, which appears to have originated from the suprasellar region with well-defined margins and tumor causing compression of the chiasm. The pituitary stalk is not regarded as a structure separate from the mass. (c and d) T1-weighted contrast-enhanced sagittal and coronal MRI scans for the same patient showed no regrowth or residual mass adherent to the pituitary stalk 11 months post-operatively. (e) CT contrast-enhanced axial scans showing the heterogeneous enhancement of the lesion prior to surgery.

Figure 2

(a and b) T1W1-weighted contrast-enhanced sagittal and coronal MRI scans showing the heterogeneous enhancement of the suprasellar mass, which appears to have originated from the suprasellar region with well-defined margins and tumor causing compression of the chiasm. The pituitary stalk is not regarded as a structure separate from the mass. (c and d) T1-weighted contrast-enhanced sagittal and coronal MRI scans for the same patient showed no regrowth or residual mass adherent to the pituitary stalk 11 months post-operatively. (e) CT contrast-enhanced axial scans showing the heterogeneous enhancement of the lesion prior to surgery.

Figure 2

(a and b) T1W1-weighted contrast-enhanced sagittal and coronal MRI scans showing the heterogeneous enhancement of the suprasellar mass, which appears to have originated from the suprasellar region with well-defined margins and tumor causing compression of the chiasm. The pituitary stalk is not regarded as a structure separate from the mass. (c and d) T1-weighted contrast-enhanced sagittal and coronal MRI scans for the same patient showed no regrowth or residual mass adherent to the pituitary stalk 11 months post-operatively. (e) CT contrast-enhanced axial scans showing the heterogeneous enhancement of the lesion prior to surgery.

Figure 2

(a and b) T1W1-weighted contrast-enhanced sagittal and coronal MRI scans showing the heterogeneous enhancement of the suprasellar mass, which appears to have originated from the suprasellar region with well-defined margins and tumor causing compression of the chiasm. The pituitary stalk is not regarded as a structure separate from the mass. (c and d) T1-weighted contrast-enhanced sagittal and coronal MRI scans for the same patient showed no regrowth or residual mass adherent to the pituitary stalk 11 months post-operatively. (e) CT contrast-enhanced axial scans showing the heterogeneous enhancement of the lesion prior to surgery.

Figure 2

(a and b) T1W1-weighted contrast-enhanced sagittal and coronal MRI scans showing the heterogeneous enhancement of the suprasellar mass, which appears to have originated from the suprasellar region with well-defined margins and tumor causing compression of the chiasm. The pituitary stalk is not regarded as a structure separate from the mass. (c and d) T1-weighted contrast-enhanced sagittal and coronal MRI scans for the same patient showed no regrowth or residual mass adherent to the pituitary stalk 11 months post-operatively. (e) CT contrast-enhanced axial scans showing the heterogeneous enhancement of the lesion prior to surgery.

Figure 3

(a) Microphotographs of the H&E sections show bipolar spindle cells with no pleomorphism and mitotic activity; original magnification, × 100. (b) Immunohistochemically, the tumor shows strong and diffuse staining for S-100 in the cytoplasm and nuclei of the tumor cells; original magnification, × 100. (c) Immunohistochemically, cytoplasmic and focal nuclear immunoreactivity for vimentin is shown; original magnification, × 100. (d) Immunohistochemically, the tumor shows strong and diffuse staining for epithelial membrane antigen; original magnification, × 200.

Figure 3

(a) Microphotographs of the H&E sections show bipolar spindle cells with no pleomorphism and mitotic activity; original magnification, × 100. (b) Immunohistochemically, the tumor shows strong and diffuse staining for S-100 in the cytoplasm and nuclei of the tumor cells; original magnification, × 100. (c) Immunohistochemically, cytoplasmic and focal nuclear immunoreactivity for vimentin is shown; original magnification, × 100. (d) Immunohistochemically, the tumor shows strong and diffuse staining for epithelial membrane antigen; original magnification, × 200.

Figure 3

(a) Microphotographs of the H&E sections show bipolar spindle cells with no pleomorphism and mitotic activity; original magnification, × 100. (b) Immunohistochemically, the tumor shows strong and diffuse staining for S-100 in the cytoplasm and nuclei of the tumor cells; original magnification, × 100. (c) Immunohistochemically, cytoplasmic and focal nuclear immunoreactivity for vimentin is shown; original magnification, × 100. (d) Immunohistochemically, the tumor shows strong and diffuse staining for epithelial membrane antigen; original magnification, × 200.

Figure 3

(a) Microphotographs of the H&E sections show bipolar spindle cells with no pleomorphism and mitotic activity; original magnification, × 100. (b) Immunohistochemically, the tumor shows strong and diffuse staining for S-100 in the cytoplasm and nuclei of the tumor cells; original magnification, × 100. (c) Immunohistochemically, cytoplasmic and focal nuclear immunoreactivity for vimentin is shown; original magnification, × 100. (d) Immunohistochemically, the tumor shows strong and diffuse staining for epithelial membrane antigen; original magnification, × 200.