Presentation
We present a report of two patients with pituicytomas and review the literature regarding treatment and prognosis for this unusual lesion. Possible histogenetic relationships of this tumor with other pituitary neoplasms are presented. [ncbi.nlm.nih.gov]
Entire Body System
- Asymptomatic
Reported herein is a case of asymptomatic pituicytoma, discovered at autopsy, in a 54-year-old Japanese woman. [ncbi.nlm.nih.gov]
Many are asymptomatic, with the lesion only found incidentally. Pituicytomas are classified as WHO grade 1 tumors and are usually indolent. [radiopaedia.org]
They may present with visual field defects, or by asymptomatic during life and discovered only at autopsy or on MRIs done for other purposes. They usually don't show diabetes insipidus in spite of their location. [pituitary.org]
As in our case, the pituicytoma was asymptomatic and incidentally detected during operation for CD. 2 The authors wondered whether an association between pituicytomas and endocrine tumors actually exists or whether, in their case, it was coincidental. [pediatrics.aappublications.org]
- Weakness
Rivera-Woll, M.B., B.S. 9 Citing Articles A 43-year-old man, who is an identical twin, presented with a 2-year history of lethargy, weakness, and headaches and a several-year history of gradual loss of body hair and declining libido. [nejm.org]
A 66-year-old man presented with lassitude, weakness, poor balance, impaired vision, and headache. [archivesofpathology.org]
Rose 2 Presentation and History 43-year-old man (an identical twin) presents with 2-year history of lethargy, weakness, headaches; several-year history of gradual loss of body hair and declining libido. Left orchidopexy at 6 years of age. [slideplayer.com]
Eventually, however, these tumors can grow large enough to cause significant health problems such as vision loss, dizziness, headaches, unintended weight loss or weight gain, weakness, body hair loss and hormone deficiencies. [cityofhope.org]
- Pallor
A physical examination revealed features of hypopituitarism and hypogonadism, including central adiposity, nipple pallor, proximal muscle wasting, preservation of scalp hair, loss of body hair, gynecomastia, and right and left testicular volumes of 12 [nejm.org]
Physical Exam Shows features of hypopituitarism and hypogonadism, including central adiposity, nipple pallor, proximal muscle wasting, preservation of scalp hair, loss of body hair, gynecomastia, and right and left testicular volumes of 12 ml and 5 ml [slideplayer.com]
Gastrointestinal
- Nausea
Postoperatively, the patient experienced nausea and vomiting, and his skin was abnormally dry. [ncbi.nlm.nih.gov]
[…] bitemporal hemianopsia; "Big Robbins" contains an error here) or optic nerves (blindness in one eye); (3) enlarged sella turcica on skull x-rays, again due to expanding masses; (4) least often, signs of increased intracranial pressure (i.e., headache, nausea [pathguy.com]
- Vomiting
Postoperatively, the patient experienced nausea and vomiting, and his skin was abnormally dry. [ncbi.nlm.nih.gov]
[…] hemianopsia; "Big Robbins" contains an error here) or optic nerves (blindness in one eye); (3) enlarged sella turcica on skull x-rays, again due to expanding masses; (4) least often, signs of increased intracranial pressure (i.e., headache, nausea and vomiting [pathguy.com]
Neurologic
- Dizziness
A 26-year-old woman presented with a 4-month history of dizziness and visual obscuration. A magnetic resonance image revealed a pituitary mass with suprasellar extension. [ncbi.nlm.nih.gov]
- Seizure
Apart from a seizure, the patient's postoperative recovery on pituitary-replacement therapy has been uneventful, with resolution of his symptoms. [nejm.org]
Followup Apart from a seizure, patient's postoperative recovery on pituitary-replacement therapy has been uneventful, with resolution of his symptoms. Newnham, H.H. & L.M. [slideplayer.com]
This hamartoma was associated with PP and gelastic seizures. B, Sagittal MRI view of the same patient showing the hamartoma (closed arrow) protruding into the third ventricle (arrowhead). [es.slideshare.net]
Low blood tonicity leads to seizures and then to death. Correct it too fast by pushing in sodium, and your patient develops central pontine myelinolysis. Be sure you know what you're doing. [pathguy.com]
Workup
During the course of his workup, an MRI of the brain was performed, which showed a pituitary/sellar mass. In 1997, the patient had a recurrence of the tumor and underwent surgery, which suggested the diagnosis of pituicytoma. [academic.oup.com]
The lab workup of acromegaly is straightforward. Your screening test is a spot blood insulin-like growth factor I (IGF-I). If this is normal, acromegaly is unlikely. [pathguy.com]
Treatment
Tumor resection is the primary treatment option, but remains subtotal due to excessive bleeding in many cases. The search for alternative or additional treatment regimens is necessary. [ncbi.nlm.nih.gov]
Treatment Review Less than 50 cases have been reported in the world literature till 2013 13). [operativeneurosurgery.com]
Total resection is the treatment of choice, since subtotal removal can often lead to recurrence or progression. [endocrine-abstracts.org]
To round out the clinician's understanding of the illness, a patient describes the experience of diagnosis, treatment, and follow-up. [books.google.com]
Prognosis
The prognosis and role of adjuvant therapy remain unclear for this discrete noninfiltrative glioma. [ncbi.nlm.nih.gov]
This fourteenth volume of the series provides comprehensive, current information on the diagnosis, therapy and prognosis of brain tumors and spinal tumors. [books.google.com]
Pituicytomas are low-grade tumors, and prognosis is good after total resection. [orpha.net]
Etiology
Although three cases of pituicytoma with elevated plasma adrenocorticotropic hormone (ACTH) have been reported previously, the etiological mechanisms remain unknown. [file.scirp.org]
Little is known of the etiology or genetics (J. Neurosurg. 98 : 162, 2003). Grossly, most of these tumors usually filled with little cysts that contain an unsavory, cholesterol-rich fluid ("machine oil"). [pathguy.com]
Epidemiology
Epidemiology PTs had a higher prevalence in the fifth and sixth decades of life, with a slight male predominance. 6). [operativeneurosurgery.com]
[…] protein and GFAP Surgical resection is curative; excellent outcome Terminology Not recommended: Infundibuloma Low grade glioma of sella and suprasellar region Pilocytic astrocytoma ICD coding ICD-0: 9432/1 - Pituicytoma ICD-11: XH59V4 - Pituicytoma Epidemiology [pathologyoutlines.com]
However, the epidemiology is not well known because of low incidence of the tumor. The clinical symptoms of pituicytomas are variable according to tumor size and location. [btrt.org]
Pathophysiology
2007;156:203) About 50% of posterior pituitary tumors (World Neurosurg 2021;145:148) Usually in adults: 40 - 60 years No obvious male or female predominance Exceptional in children (3% of posterior pituitary tumors) Sites Sella and suprasellar region Pathophysiology [pathologyoutlines.com]
[…] pituitary { 02294 } anterior pituitary, histology; curious stain, don't worry about the colors { 14948 } posterior pituitary, histology (arrow: Herring body) OBJECTIVES; Know when to suspect each of these clinical syndromes, and give the likely etiologies, pathophysiology [pathguy.com]
Prevention
We removed the suprasellar tumor by the transcranial approach to decompress the optic nerves and chiasm to prevent permanent visual loss after angiography and recognition of the unusual pathology. [btrt.org]
POU1F prevents productions of GH, prolactin, and TSH (J. Clin. Endo. Metab. 90 : 4762, 2005). Even ACTH usually is insufficient: J. Clin. Endo. Metab. 89 : 5256, 2004. [pathguy.com]
At present, most patients are treated as having a clinically nonfunctioning adenoma, and the therapeutic goals are restoration of visual deficits, preservation of pituitary function, and prevention of recurrence. [15] Null cell adenomas and oncocytomas [emedicine.medscape.com]