Endocrine Abstracts

Introduction: Pituicytoma is a rare, primary benign, tumor of the sellar and suprasellar regions which is arising from pituicytes of the neurohypophysis and infundibulum and mainly affects middle age adults. We present here such a case

Presentation: A 64-years-old man was referred to our clinic. For further investigation of a sellar lesion with suprasellar extension. The patient underwent investigations due to visual disturbances which he noticed initially 6 months ago and gradually became worse. On opthalmological examination he found to have bitemporal hemianopsia and magnetic resonance imaging (MRI) of the brain and the pituitary revealed a well-circumscribed lesion about 2×2×1.8 cm in size in sellar region with suprasellar extension, compressing the optic chiasm. The lesion was isointense on T1- and T2-weighted images, with heterogeneous enhancement following intravenous administration of Gd-DTPA. Clinical examination and laboratory testing did not reveal any hormonal deficiencies. Trans-sphenoidal surgery was carried out for optic nerve decompression, but full removal of the lesion was not possible due to bleeding during the operation. Histopathological examination revealed tumor cells spindle shaped, with unclear boundary and abundant cytoplasm. The tumor displayed diffuse immunoreastivity for TTF-1, S-100, focally GFAP and vimentin. These findings are typical features of pituicytoma. Following the surgery, the patient developed transient diabetes insipidus and his bitemporal hemianopsia was improved.

Conclusions: Pituicytoma is a rare tumor with less than 200 patients to be reported in the literature. It can be detected either as an incidental finding due to increasing imaging or due to symptomatology related to location and the tumor size. Clinical symptoms can include visual disturbances, headache and hypopituitarism. The diagnosis is based on histopathological examination which reveals the typical morphological and immunohistochemical features of pituicytoma.