scholarly journals Pituitary spindle cell oncocytoma: illustrative case

2021 ◽  
Vol 2 (14) ◽  
Author(s):  
Taha M. Taka ◽  
Chen Yi Yang ◽  
Joshua N. Limbo ◽  
Alvin Y. Chan ◽  
Jordan Davies ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Spindle Cell ◽  
Pituitary Tumors ◽  
World Health ◽  
Preoperative Imaging ◽  
Illustrative Case ◽  
Structure Damage ◽  
Secondary Hypothyroidism ◽  
Increased Risk ◽  
Spindle Cell Oncocytoma

BACKGROUND Spindle cell oncocytoma (SCO) of the pituitary gland is an extremely rare nonfunctional World Health Organization grade I tumor. SCOs are often misdiagnosed as nonfunctional pituitary adenomas on the basis of preoperative imaging. They are often hypervascular and locally adherent, which increases hemorrhage risk and limits resection, leading to increased risk of recurrence. The authors report a case of SCO treated at their institution and provide a review of the current literature. OBSERVATIONS SCO of the pituitary gland can be a rare cause of progressively growing pituitary tumors that presents similarly to nonfunctional pituitary adenoma. Endoscopic transsphenoidal resection of the tumor by a multidisciplinary team allowed total resection despite local adherence of the tumor. Postoperatively, the patient’s visual symptoms improved with persistence of secondary adrenal insufficiency and secondary hypothyroidism. LESSONS Careful resection is needed due to SCO’s characteristic hypervascularity and strong adherence to minimize local structure damage. Long-term follow-up is recommended due to the tendency for recurrence.

Granular Cell Tumor and Spindle Cell Oncocytoma of the Pituitary Gland: Imaging and Intraoperative Cytology Diagnostic Dilemmas and Management Challenges

2021 ◽  
Author(s):  
Sandeep Kandregula ◽  
Abhinith Shashidhar ◽  
Shilpa Rao ◽  
Manish Beniwal ◽  
Dhaval Shukla ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Vision Loss ◽  
Spindle Cell ◽  
Pituitary Tumors ◽  
Granular Cell ◽  
Preoperative Imaging ◽  
Posterior Pituitary ◽  
Intraoperative Cytology ◽  
Transcranial Approach

Abstract Background Tumors arising from the posterior pituitary gland are rare and closely resemble pituitary adenoma in presentation and imaging. Most of them come as a histopathologic surprise. We have analyzed the posterior pituitary tumors managed in our institute and have discussed the dilemmas in imaging, challenges in intraoperative squash cytology, and surgical management. Methods We retrospectively reviewed our operative database of pituitary tumors over the past 10 years, which included five posterior pituitary tumors (three granular cell tumors [GCTs] and two spindle cell oncocytomas [SCOs]). Clinical, imaging, and endocrine characteristics; intraoperative details; histopathologic features; and postoperative outcomes were collected and analyzed. Results The mean age of the patients was 47 years. All patients presented with varying degrees of vision loss. Radiology revealed a sellar / suprasellar lesion with the pituitary gland seen separately in two of three GCTs, whereas a separate pituitary gland could not be identified in both the SCOs. Pituitary adenoma was a radiologic diagnosis in only two of five cases. Three patients underwent a transsphenoidal surgery, whereas two underwent surgery by the transcranial approach. Intraoperative cytology was challenging, though a possibility of posterior pituitary tumor was considered in three of four cases, whereas one was considered meningioma. All the tumors were very vascular and influenced the extent of resection. Conclusions GCTs and SCOs are relatively uncommon tumors that are difficult to diagnose on preoperative imaging. Intraoperative squash cytology too can pose challenges. A preoperative suspicion can prepare the surgeon for surgery of these hypervascular tumors. The transcranial approach may be necessary in cases of uncertainty in imaging.

Differentially expressed miRNAs in spindle cell oncocytoma of the pituitary gland

2019 ◽  
Author(s):  
Lilla Krokker ◽  
Gabor Nyirő ◽  
Lilla Reininger ◽  
Otto Darvasi ◽  
Nikolette Szucs ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Spindle Cell ◽  
Differentially Expressed ◽  
Differentially Expressed Mirnas ◽  
Spindle Cell Oncocytoma

Arterial Embolization and Second-Look in Spindle Cell Oncocytoma of the Pituitary Gland: Case Report and Review of Literature

2020 ◽  
Vol 142 ◽  
pp. 87-92
Author(s):  
Leonardo Tariciotti ◽  
Antonio Arrichiello ◽  
Giorgio Fiore ◽  
Giulio Bertani ◽  
Giorgio Conte ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Gland ◽  
Spindle Cell ◽  
Arterial Embolization ◽  
Review Of Literature ◽  
Second Look ◽  
Spindle Cell Oncocytoma

scholarly journals Spindle cell oncocytoma of the pituitary gland

2019 ◽  
Vol 131 (2) ◽  
pp. 517-525 ◽  
Author(s):  
Alexandra M. Giantini Larsen ◽  
David J. Cote ◽  
Hasan A. Zaidi ◽  
Wenya Linda Bi ◽  
Paul J. Schmitt ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Spindle Cell ◽  
Histopathological Examination ◽  
S100 Protein ◽  
Residual Tumor ◽  
Pituitary Hormones ◽  
Postoperative Management ◽  
Clinical Findings ◽  
Thyroid Transcription Factor 1 ◽  
Spindle Cell Oncocytoma

OBJECTIVEThe authors report the diagnosis, management, and outcomes of 6 cases of spindle cell oncocytoma (SCO) in an effort to guide clinical diagnosis and management of these uncommon lesions.METHODSThis study is a retrospective review of cases involving adult patients who underwent resection of pituitary lesions at the authors’ institutions between January 2000 and October 2017. The authors identified patients with histopathological confirmation of SCO and collected clinical data, including preoperative, perioperative, and postoperative management, complications, and outcomes.RESULTSSix patients with SCO were identified. Clinical findings at initial presentation included visual disturbances, dizziness, and headache. All patients underwent resection. Four resections were initially performed by the transsphenoidal approach, and 2 resections were performed by craniotomy at an outside institution with subsequent transsphenoidal reoperations. Neither necrosis nor increased mitotic activity was seen in the tumor samples. All samples stained positive for S100 protein and thyroid transcription factor 1 and negative for glial fibrillary acidic protein and pituitary hormones. Five of the samples stained positive for epithelial membrane antigen. The average MIB-1 index was 8.3% (range 2–17). Postoperatively, 3 of the 6 patients received further treatment for progression of residual tumor or for recurrence, 2 have stable residual tumor, and 1 has had no recurrence after gross-total resection. Two patients developed postoperative complications of transient sixth cranial nerve palsy and diplopia. There were no other complications.CONCLUSIONSSCO poses both a diagnostic and therapeutic challenge. These tumors are often initially misdiagnosed as nonfunctional pituitary adenomas because of their sellar location and nonspecific symptomatology. Postoperatively, SCO must also be distinguished from other neoplasms of the posterior pituitary gland through histopathological examination. Resection of SCO can be challenging, given its highly vascular and adherent nature. Long-term follow-up is critical, as the tumor is associated with higher recurrence and progression rates compared to other benign neoplasms of the sella.

scholarly journals Multifocal Primary Neoplasms in Kidney Allografts: Evaluation of Two Cases

2016 ◽  
Vol 3 (2) ◽  
pp. 14-22 ◽  
Author(s):  
Robert J Ellis ◽  
Keng Lim Ng ◽  
Hemamali Samaratunga ◽  
Sharon J Del Vecchio ◽  
Simon T Wood ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Spindle Cell ◽  
De Novo ◽  
Spindle Cell Carcinoma ◽  
World Health ◽  
Renal Neoplasm ◽  
Kidney Transplant Recipients ◽  
Renal Sinus ◽  
Increased Risk ◽  
Health Organization

Renal cell carcinoma (RCC) is the fifth most common malignancy in kidney transplant recipients, with increased risk arising due to immunosuppression. De novo RCC occurrence in kidney allografts is much less common when compared with the native kidneys. Multifocal RCC in allograft kidneys is rarely described. In this report, we discuss two cases of de novo multifocal renal neoplasms in allograft kidneys. Case 1 had three distinct neoplastic lesions of >5 mm, and case 2 had four. Using the World Health Organization 2016 classification of adult renal tumours, case 1 had one clear-cell (cc) RCC (grade 3) and two papillary adenomas; all confined to the kidney. Case 2 had a nodular lesion classified as ccRCC (grade 4) with focal rhabdoid differentiation and some infiltration of renal sinus fat; a cc tubulopapillary RCC; a multilocular cystic renal neoplasm of low malignant potential; and a mucinous tubular and spindle cell carcinoma; the last three all confined to the kidney. This is the first report of mucinous tubular and spindle cell carcinoma in a kidney allograft. When considering multifocal RCC with discordant histology, it is likely that these represent independent tumourigenic events.

scholarly journals Teaching NeuroImage: Spindle cell oncocytoma of the pituitary gland

Neurology ◽  
2008 ◽  
Vol 71 (2) ◽  
pp. e3-e3 ◽  
Author(s):  
M. U. Farooq ◽  
A. Bhatt ◽  
H. T. Chang
Keyword(s):  
Pituitary Gland ◽  
Spindle Cell ◽  
Spindle Cell Oncocytoma

A Comprehensive Study of Spindle Cell Oncocytoma of the Pituitary Gland: Series of 6 Cases and Meta-Analysis of 85 Cases

2021 ◽  
Vol 149 ◽  
pp. e197-e216
Author(s):  
Hirotaka Hasegawa ◽  
Jamie J. Van Gompel ◽  
Soliman H. Oushy ◽  
Bruce E. Pollock ◽  
Michael J. Link ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Spindle Cell ◽  
Meta Analysis ◽  
Spindle Cell Oncocytoma ◽  
Comprehensive Study

Development of a histological pseudocapsule and its use as a surgical capsule in the excision of pituitary tumors

2006 ◽  
Vol 104 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Edward H. Oldfield ◽  
Alexander O. Vortmeyer
Keyword(s):  
Pituitary Gland ◽  
Surgical Techniques ◽  
Pituitary Tumors ◽  
Pituitary Surgery ◽  
Surrounding Tissue ◽  
Maximum Diameter ◽  
Preoperative Imaging ◽  
Tumor Diameter ◽  
Cushing Disease ◽  
Pituitary Glands

Object The presence of a histological pseudocapsule around pituitary tumors was noted in the early 1900s. Since that time there has been no emphasis on the sequence of the stages of its development or on the relationship between these stages and the capacity to identify very small pituitary tumors at surgery in patients in whom preoperative imaging has been nondiagnostic. In addition, limited emphasis has been given to the pseudocapsule’s use for selective and complete resection of pituitary adenomas. Methods The development of the pseudocapsule was examined by performing histological analysis of portions of pituitary glands removed during 805 operations for Cushing disease. Twenty-five adenomas, each measuring between 0.25 and 4 mm in maximum diameter, were detected in the excised specimens; 17 were adenocorticotropic hormone–positive adenomas and eight were incidental tumors (four prolactin-secreting and four nonsecreting lesions). In 16 tumors the size of the adenoma could be established. The distribution of tumor size in relation to the presence of a histological pseudocapsule indicates a transition from the absence of a reticulin capsule (tumor diameter ≤ 1 mm) through the initial compression of surrounding tissue (tumor diameter 1–2 mm) to the presence of a multilayered reticulin capsule observed when adenomas become larger (tumor diameter 2–3 mm). Conclusions The absence of a reticulin capsule in cases of very small tumors may contribute to limited localization of these lesions during surgical exploration of the pituitary gland. In this article the authors describe surgical techniques in which the histological pseudocapsule is used as a surgical capsule during pituitary surgery. In their experience, recognition of this surgical capsule and its use at surgery has contributed to the identification of microadenomas buried in the pituitary gland, aided the recognition of subtle invasion of the pituitary capsule and contiguous dura mater, and enhanced the consistency of complete tumor excision with small and large tumors.

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