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Pituitary

, Volume 17, Issue 5, pp 399–413 | Cite as

Surgical management of pituicytomas: case series and comprehensive literature review

  • Ming Feng
  • John D. Carmichael
  • Vivien Bonert
  • Serguei Bannykh
  • Adam N. Mamelak
Article

Abstract

Objective

Pituicytomas are rare neoplasms that typically present as solid, noninfiltrative tumors occupying the sella and/or suprasellar space for which there is no consensus on optimal surgical management. We aimed to define a preferred surgical strategy for these tumors based on our clinical experience and comprehensive review of the world literature.

Design

Case series and review of the literature.

Methods

We documented the clinical, radiographic, and surgical findings of three patients with pituicytoma treated at our institution, as well as complications and long-term outcomes. A comprehensive review of the medical literature identified all cases of pituicytoma for which data regarding surgical approach, outcome and complications could be extracted. We compared our results with published data.

Results

All three cases at our institution achieved gross total removal. Two patients underwent an expanded endoscopic endonasal transsphenoidal and transplanum (EETS-TP) approach, while one tumor was removed via craniotomy. Post-operatively all patients developed pan-hypopitutarism. The patient undergoing craniotomy suffered profound visual loss but no other neurological complications were noted. A literature review identified 67 reported cases of pituicytoma. Surgical data was available in 60 cases. Surgical approach was documented in 57 patients. Sixty-three surgeries were performed in which approach and extent of resection was available. Gross total removal was obtained in 33 % of craniotomies, 42 % of transsphenoidal procedures, and 100 % of expanded transsphenoidal procedures. Neurological complications including visual loss, hemiparesis and cranial nerve palsies were reported after craniotomy, but not after transsphenoidal approaches. Overall EETS-TP approaches were associated with the highest rate of gross total removal and no visual or neurological complications.

Conclusions

EETS-TP surgery is the preferred strategy for surgical removal of pituicytoma. EETS-TP and transsphenoidal approaches are associated with higher rates of gross total removal and lower rates of neurological complications than craniotomy. Gross total removal should be the intended goal of surgery.

Keywords

Pituicytoma Outcome Complications Endoscope Transsphenoidal Craniotomy 

Abbreviations

CSF

Cerebrospinal fluid

EMA

Epithelial membrane antigen

GFAP

Glial fibrillary acidic protein

DI

Diabetes insipidus

TS

Transsphenoidal

Crani

Craniotomy

EETS-TP

Endoscopic endonasal transsphenoidal transplanum

Notes

Conflict of interest

The authors report no conflicts of interest or financial disclosures/nothing to declare.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ming Feng
    • 1
  • John D. Carmichael
    • 2
  • Vivien Bonert
    • 2
  • Serguei Bannykh
    • 3
  • Adam N. Mamelak
    • 4
  1. 1.Department of NeurosurgeryPeking Union Medical College HospitalBeijingChina
  2. 2.Endocrinology Division, Department of MedicineCedars-Sinai Medical CenterLos AngelesUSA
  3. 3.Department of PathologyCedars-Sinai Medical CenterLos AngelesUSA
  4. 4.Department of NeurosurgeryCedars-Sinai Medical CenterLos AngelesUSA

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