Posterior pituitary tumours: the spectrum of a unique entity. A clinical and histological study of a large case series

Guerrero-Pérez, Fernando; Vidal, Noemí; Marengo, Agustina Pia; Pozo, Carlos del; Blanco, Concepción; Rivero-Celada, David; Díez, Juan J.; Iglesias, Pedro; Picó, Antonio; Villabona, Carles

doi:10.1007/s12020-018-1774-2

Cited by 24 publications

(21 citation statements)

References 47 publications

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“…A recent systematic review identified 266 patients with a pathological diagnosis of posterior pituitary tumours (135 pituicytomas, 69 GCT, 47 SCO, eight SE and seven mixed histology tumours). Pre‐operative DI was present at diagnosis in only 2.2% (six cases), whereas the frequency of post‐operative DI increased in 33% 90 …”

Section: Discussionmentioning

confidence: 93%

“…logical diagnosis of posterior pituitary tumours (135 pituicytomas, 69 GCT, 47 SCO, eight SE and seven mixed histology tumours).Pre-operative DI was present at diagnosis in only 2.2% (six cases), whereas the frequency of post-operative DI increased in 33% 90. The absence of the bright spot of the posterior pituitary on T1weighted images is a supportive MRI finding for the diagnosis of DI in the presence of a relevant clinical setting, although it is not diagnostic.…”

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confidence: 99%

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Diabetes insipidus secondary to sellar/parasellar lesions

Angelousi

Mytareli

Xekouki

et al. 2021

J Neuroendocrinology

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Diabetes insipidus (DI) is a well‐recognised transient or permanent complication following transsphenoidal surgery for pituitary adenomas or other sellar/parasellar lesions. However, data regarding the prevalence of pre‐operative DI in sellar/parasellar lesions other than pituitary adenomas are scarce. We systematically reviewed the existing data for defining the prevalence of DI before any treatment in adult patients with sellar/parasellar lesions, excluding pituitary adenomas and metastatic lesions. In total, 646 patients with sellar/parasellar lesions presenting with DI at diagnosis were identified. The most common pathologies of sellar/parasellar lesions presenting with DI at diagnosis were lymphocytic hypophysitis (26.5%), craniopharyngiomas (23.4%), Langerhans's cell histiocytosis (18.9%) and Rathke's cleft cyst (12.7%), accounting for the vast majority (more than 80%) of these lesions. Overall, DI at diagnosis was found in 23.4% of all patients with sellar/parasellar lesions, albeit with a wide range from 10.6% to 76.7%, depending on the nature of the pathology. The highest prevalence of DI was found in less commonly encountered lesions namely germ‐cell tumours (76.7%), abscesses (55.4%) and neurosarcoidosis (54.5%), each accounting for less than 3% of all sellar/parasellar lesions. Most DI cases (68.8%) were associated with anterior pituitary hormonal deficiencies, in contrast to pituitary adenomas that rarely present with DI. The enlargement and enhancement of the pituitary stalk were the most common findings on magnetic resonance imaging besides the loss of the high signal of the posterior pituitary on T1‐weighted images. Resolution of DI spontaneously or following systemic and surgical management occurred in 22.4% of cases. Post‐operative DI, not evident before surgery, was found in 27.8% of non‐adenomatous sellar/parasellar lesions, and was transient in 11.6% of them. Besides distinctive imaging features and symptoms, early recognition of DI in such lesions is important because it directs the diagnosis towards a non‐adenomatous sellar/parasellar tumour and the early initiation of appropriate treatment.

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

Diabetes insipidus secondary to sellar/parasellar lesions

Angelousi

Mytareli

Xekouki

et al. 2021

J Neuroendocrinology

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“…IHC in reported cases has shown the variable and non-universal presence of TTF-1 despite it being regarded as the histological hallmark of these tumours. Among other IHC markers, S-100, vimentin, EMA, GFAP and galectin-3 have been reported in various series with GFAP positivity mostly in pituicytomas and EMA in SCO ( 4 , 18 ). Furthermore, these tumours are negative for adenohypophyseal hormones and chromogranin A, indicating their histologically ‘neuronal’ rather than ‘neuroendocrine’ nature.…”

Section: Discussionmentioning

confidence: 98%

“…Surgery is the treatment of choice for symptomatic PPT usually by the transsphenoidal route (TSS). However, PPTs, including both pituicytomas and SCOs, often show recurrence/persistence following surgery ( 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ).…”

Section: Introductionmentioning

confidence: 99%

Posterior pituitary tumours: patient outcomes and determinants of disease recurrence or persistence

Das

Vaiphei

Rai

et al. 2021

Endocrine Connections

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Objective: Posterior pituitary tumours (PPTs) are rare neoplasms with the four recognised subtypes unified by thyroid transcription factor-1 (TTF-1) expression, according to the 2017 WHO classification. Though traditionally defined as low grade neoplasms, a substantial proportion of them show recurrence/persistence following surgery. Methods: We selected patients with PPTs in our cohort of 1760 patients operated for pituitary tumours over the past ten years. The clinical, radiological, hormonal, histopathological profiles and long-term outcomes of the three cases identified (two pituicytomas and one spindle cell oncocytoma, SCO) were analysed. Following a literature review, data of all published cases with documented TTF-1 positive pituicytomas and SCOs were analysed to determine the predictors of recurrence/persistence in these tumours. Results: Patients presented with compressive features or hypogonadism. Two had sellar-suprasellar masses. One had a purely suprasellar mass with a pre-operative radiological suspicion of pituicytoma. Two were operated by transsphenoidal surgery and one transcranially guided by neuronavigation. Histopathology confirmed spindle cells in a storiform arrangement and low Ki67 index. Immunohistochemistry showed positive TTF-1, S-100 expression and variable positivity for EMA, vimentin and GFAP. Re-evaluation showed recurrence/persistence in two patients. A literature review of recurrent/persistent pituicytoma (n=17) and SCO (n=9) cases revealed clinical clues (headache for pituicytomas, male gender for SCO), baseline tumour size (≥20.5mm with sensitivity exceeding 80%) and longer follow-up duration as determinants of recurrence/persistence. Conclusion: PPTs are rare sellar masses with quintessential TTF-1 positivity. Recurrent/persistent disease following surgery is determined by greater tumour size at baseline and duration of follow-up. This warrants intensive and long-term surveillance in these patients.

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“…Until mid-2017, there have been only 34 cases published [3]. Although some hormonally active oncocytomas have been described [6, 7], PPTs are low-grade, non-neuroendocrine neoplasms clinically presenting with symptoms related to mass effects [4, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

Differentially Expressed miRNAs Influence Metabolic Processes in Pituitary Oncocytoma

et al. 2019

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Spindle cell oncocytomas (SCO) of the pituitary are rare tumors accounting for 0.1–0.4% of all sellar tumors. Due to their rarity, little information is available regarding their pathogenesis. Our aim was to investigate miRNA expression profile of pituitary oncocytomas. Total RNA was extracted from 9 formalin-fixed paraffin embedded pituitary samples (4 primary, 3 recurrent oncocytomas and 2 normal tissues). Next-generation sequencing was performed for miRNA profiling. Transcriptome data of additional 6 samples’ were obtained from NBCI GEO database for gene expression reanalysis and tissue-specific target prediction. Bioinformatical analysis, in vitro miRNA mimics transfection, luciferase reporter system and AlamarBlue assay were applied to characterize miRNA’s function. 54 differentially expressed miRNAs and 485 genes in pituitary SCO vs. normal tissue and 8 miRNAs in recurrent vs. primary SCO were determined. Global miRNA downregulation and decreased level of DROSHA were detected in SCO samples vs. normal tissue. Transcriptome analysis revealed cell cycle alterations while miRNAs influenced mainly metabolic processes (tricarboxylic acid cycle-TCA, carbohydrate, lipid metabolism). Through miRNA-target interaction network the overexpressed Aconitase 2 potentially targeted by two downregulated miRNAs (miR-744-5p, miR-127-3p) was revealed. ACO2 and miR-744-5p interaction was validated by luciferase assay. MiR-127-3p and miR-744-5p significantly decreased cell proliferation in vitro. Our study firstly reported miRNA profile of pituitary oncocytoma. Our results suggest that tumor suppressor miRNAs may have an essential role in the pathogenesis of pituitary oncocytoma. Earlier reports showed downregulated TCA cycle in SCO which is extended by our results adding the role of miR-744-5p targeting ACO2.Electronic supplementary materialThe online version of this article (10.1007/s11064-019-02789-2) contains supplementary material, which is available to authorized users.

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Posterior pituitary tumours: the spectrum of a unique entity. A clinical and histological study of a large case series

Cited by 24 publications

References 47 publications

Diabetes insipidus secondary to sellar/parasellar lesions

Diabetes insipidus secondary to sellar/parasellar lesions

Posterior pituitary tumours: patient outcomes and determinants of disease recurrence or persistence

Differentially Expressed miRNAs Influence Metabolic Processes in Pituitary Oncocytoma

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