A Rare Pituitary Tumor

Abstract

Sellar-suprasellar masses, with diverse origins ranging from infiltrative to neoplastic processes, are frequently encountered in endocrinology clinics. Evaluation involves a detailed history, hormone analysis, and imaging of the hypothalamic-pituitary axis. However, overlapping hormonal and imaging features can complicate diagnosis, often necessitating confirmation through tissue biopsy. Pituicytoma, a rare sellar tumor mimicking other masses biochemically and radiologically, exemplifies this challenge. These are benign intracranial neoplasms with characteristic bipolar spindle-shaped astrocytic cells organized in fascicular or storiform patterns with specific immunohistochemistry. The current case is of an elderly postmenopausal woman with a history of hypertension who presented with recurrent headaches and transient vision loss in the left eye. Imaging studies revealed a suprasellar mass, which was biopsied and diagnosed on histopathological examination as a pituicytoma. This case highlights the importance of considering less common etiologies when encountering such presentations.

Keywords: endocrinology; pituitary; pituitary dysfunction; pituitary tumour pituicytoma; rare tumor; supra sellar mass.

Figure 1. Saggital T1-weighted MRI image showing an isointense lesion in the sellar and suprasellar region

Figure 2. Axial image showing a FLAIR hyperintense lesion in the sellar region

Figure 3. Sagittal postcontrast T2 image showing a heterogeneously enhanced sellar and suprasellar lesion causing expansion of sella turcica

Figure 4. Short fascicles of spindled to polygonal cells (A, H&E), which are labeled by vimentin (B) and GFAP (C) and show low proliferation (D, MIB 1)

GFAP, glial fibrillary acidic protein