ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Pituicytoma: a rare tumour
Diana Oliveira 1 , Leonor Gomes 1 , Dírcea Rodrigues 1 , Francisco Belo 2 , Olinda Rebelo 3 , Sandra Paiva 1 , Carolina Moreno 1 , Daniela Guelho 1 , Ana Margarida Balsa 4 , Nuno Vicente 1 , Luís Cardoso 1 , Diana Martins 1 & Francisco Carrilho 1
1Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Centre, Coimbra, Portugal; 2Neurosurgery Department, Coimbra Hospital and University Centre, Coimbra, Portugal; 3Neuropathology Laboratory, Neurology Department, Coimbra Hospital and University Centre, Coimbra, Portugal; 4Endocrinology, Diabetes and Nutrition Department, Baixo Vouga Hospital Centre, Aveiro, Portugal.
Introduction: Pituicytoma is a low-grade glioma of the suprasellar and sellar regions that is rarely described (about 60 cases in the literature). The clinical, laboratory, and neuroradiological findings are not pathognomonic, and therefore definitive diagnosis is only possible after surgery and histopathological study. Total resection is the treatment of choice, since subtotal removal can often lead to recurrence or progression.
Case report: We report the case of a Caucasian male with no significant medical history who develops isolated frontal headache at the age of 48. Magnetic resonance imaging (MRI) revealed an expansive sellar and suprasellar lesion, with 14 mm, well-defined limits, bright homogeneous enhancement with gadolinium, associated with a slight deviation of the optic chiasm. Hormonal study was normal. The patient continued to be followed in Neurosurgery consultation and after 4 years presented complaints of gradually worsening visual disturbances, progressively decreased libido and erectile dysfunction. On visual field testing, a bitemporal hemianopia was noted. MRI revealed millimetrical increase of the tumour. He underwent transnasal/transsphenoidal surgery, which resulted in a partial removal due to difficulty in controlling bleeding. The histopathological examination showed a tumor composed of bipolar cells, with immunohistochemical positivity for vimentin and S100 protein, Ki-67 <2% – pituicytoma. The postoperative hormone study revealed panhypopituitarism. The control MRI detected significant residual tumour, so it was decided to propose the patient for radiosurgery treatment.
Conclusions: This pituicytoma case illustrates a diagnosis that, although rare, should not be excluded from the possibilities available before a suprasellar or sellar lesion that presents with certain cardinal radiological features. The persistence of significant residual tumour was due to the bleeding tendency of the lesion during surgery. Awareness of the possibitlity of pituicytoma before surgery would be ideal for appropriate treatment planning, with possible preoperative embolisation of the tumour.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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