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Endocrine

, Volume 63, Issue 1, pp 36–43 | Cite as

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

  • Fernando Guerrero-PérezEmail author
  • Noemi Vidal
  • Agustina Pia Marengo
  • Carlos Del Pozo
  • Concepción Blanco
  • David Rivero-Celada
  • Juan José Díez
  • Pedro Iglesias
  • Antonio Picó
  • Carles Villabona
Endocrine Surgery
  • 90 Downloads

Abstract

Purpose

In 2017, the WHO established that pituicytoma, granular cell tumour (GCT) and spindle cell oncocytoma (SCO) are posterior pituitary tumours (PPT). Recent data suggests that these tumours probably arise from the pituicytes and may constitute a spectrum of a unique histopathological entity. Our aim is to report the clinical findings and surgical outcomes of 16 patients with PPT. We also evaluated the tissue specimens available in light of current knowledge.

Method

Cross-sectional study with retrospective data.

Results

PPT were 7 pituicytomas, 3 GCT and 6 SCO. Patients mean age was 55 years old and 75% were female. Basal hormonal study showed hyperprolactinemia (43.7%) and hypopituitarism (37.5%). There was no case of diabetes insipidus (DI). MRI showed sellar/suprasellar masses with mean size of 19.7mm. PPT was not suspected in any patient. Fifteen patients underwent surgery and complications were common: 20% had perioperative bleeding (one patient died because of a massive haemorrhage), 57.1% hypopituitarism, 35.7% permanent DI and 21.4% underwent a second surgery. Pathological findings shown positivity for thyroid transcription factor 1, vimentin and negativity for cytokeratin and chromogranin A in all specimens evaluated. S100 protein was positive in 88.8% of tumours. Ki67 was ≥ 3% in 66.6% and ranged from 4-7% in SCO.

Conclusion

PPT have similar histology, clinical features and are frequently misdiagnosed as nonfunctioning pituitary tumours. However, post-surgical complications including haemorrhage are common. A high clinical suspicion is needed to presume the diagnosis prior surgery and diminish the high morbidity of these tumours.

Keywords

Posterior pituitary tumours Pituicytoma Granular cell tumours of the neurohypophysis Spindle cell oncocytoma 

Notes

Acknowledgements

The authors thank Georgina Petropoulos Nouna for the language review of the paper.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. The patient’s confidential information was protected according to national normative. All patients or relatives gave consent regarding participation in the study. This manuscript has been revised for its publication by the Clinical Research Ethics Committee of Bellvitge University Hospital.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Fernando Guerrero-Pérez
    • 1
    Email author
  • Noemi Vidal
    • 2
  • Agustina Pia Marengo
    • 1
  • Carlos Del Pozo
    • 3
  • Concepción Blanco
    • 4
  • David Rivero-Celada
    • 5
  • Juan José Díez
    • 6
  • Pedro Iglesias
    • 6
  • Antonio Picó
    • 7
  • Carles Villabona
    • 1
  1. 1.Department of EndocrinologyHospital Universitari de BellvitgeBarcelonaSpain
  2. 2.Department of PathologyHospital Universitari de BellvitgeBarcelonaSpain
  3. 3.Department of EndocrinologyHospital Universitari Mutua TerrassaBarcelonaSpain
  4. 4.Department of EndocrinologyHospital Universitario Príncipe de AsturiasMadridSpain
  5. 5.Department of NeurosurgeryHospital Universitario Miguel ServetZaragozaSpain
  6. 6.Department of EndocrinologyHospital Universitario Puerta de HierroMadridSpain
  7. 7.Department of EndocrinologyHospital General Universitario de AlicanteAlicanteSpain

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