Management of pituitary spindle cell oncocytomas: A case report and review of the literature

• Published in: Interdisciplinary neurosurgery : Advanced techniques and case management 2021-03, Vol.23, p.100972, Article 100972
• Main Authors: Abdulrazeq, Hael, Anderson, Matthew, Poggi, Jonathan, Sampath, Shailen, Kanach, Colin, Dellale, Ivana, Sampath, Prakash
• Format: Article
• Language: English
• Subjects: Pituitary tumors; Spindle cell oncocytoma; Transsphenoidal surgery
• ISSN: 2214-7519; 2214-7519
• DOI: 10.1016/j.inat.2020.100972

•Spindle Cell Oncocytomas (SCO) are part of a class of tumors that includes low grade pituitary tumors such as pituicytomas and granular cell tumors (GCT).•SCO are rare tumors which are typically benign, with some cases having more aggressive invasion.•This is a case report of a 74-year-old woman found to have a pituitary mass treated with partial resection, diagnosed on histopathology to be a spindle cell oncocytoma.•On 6 months follow up, surveillance MRI reveals stable appearance of the tumor. No adjuvant therapy is planned. Pituitary spindle cell oncocytomas represent a rare pathologic entity within the differential diagnosis for pituitary tumors. As part of a class of tumors that includes low grade non-endocrine pituitary tumors such as pituicytomas and granular cell tumors (GCT), these can have similar characteristics to pituitary adenomas, and are occasionally misdiagnosed as such. We present a case of a 74-year-old woman who presented for work up of persistent headaches and vertigo. MRI brain demonstrated a heterogeneously enhancing soft tissue mass at the left lateral aspect of the sella. Patient underwent a biopsy and resection of the lesion. Histopathological examination is reviewed which revealed a spindle cell oncocytoma. Follow up MRI and examination at 6 months revealed partial resection. Additionally, we present an overview of the literature on clinical characteristics of this tumor and considerations for treatment and follow up.