A rare case report of pituicytoma with biphasic pattern and admixed with scattered Herring bodies

• Published in: World journal of surgical oncology 2020-05, Vol.18 (1), p.108-108, Article 108
• Main Authors: Cao, Youde, Zeng, Yan, Qin, Xue, Tan, Yiwen, Zeng, Min, Wang, Lijuan, Cao, Xiaojing, Zou, Lingfeng, Wang, Chenglong
• Format: Article
• Language: English
• Subjects: Aged; Antigens; Biomarkers, Tumor - analysis; Blood vessels; Care and treatment; Case Report; Case reports; Case studies; Classification; Cytoplasm; Diagnosis; Diagnostic systems; Facial paralysis; Humans; Hypothalamus; Magnetic Resonance Imaging; Male; Medical prognosis; Morphology; Nervous system; Neuroendocrine tumors; Paralysis; Pathology; Patients; Perivascular pseudorosettes; Phosphopyruvate hydratase; Physical examinations; Pituicytoma; Pituitary; Pituitary Gland, Posterior - diagnostic imaging; Pituitary Gland, Posterior - pathology; Pituitary Gland, Posterior - surgery; Pituitary Neoplasms - diagnosis; Pituitary Neoplasms - pathology; Pituitary Neoplasms - surgery; Pituitary tumors; Prognosis; Proteins; Surgery; Thyroid; Thyroid gland; Transcription factors; TTF1; Tumors; Urinary incontinence
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-020-01889-6

Pituicytoma is a rare pituitary non-neuroendocrine tumour. The awareness of pituitary non-neuroendocrine tumours has gradually increased over the past several decades, but the knowledge of some histological variants of the tumours is limited, particularly in clinicopathological significance. Here, we report a rare case of pituicytoma variant. A 71-year-old man presented with sudden symptoms of stroke including urinary incontinence, weakness in right lower limb, and trouble speaking. Physical examinations showed a right facial paralysis. The radiological examinations eventually found a 1.7 × 1.4 × 1.3 cm sellar occupied lesion. After symptomatic treatment improved the symptoms, the patient underwent transsphenoidal resection of the pituitary mass. Histologically, the tumour contained hypocellular area and hypercellular area. The hypocellular area showed elongated spindle cells arranged in a fascicular pattern around small vessels and scattered Herring bodies; the hypercellular area showed a large number of pseudorosettes. Immunohistochemistrically, the tumour cells were positive for thyroid transcription factor-1, S100, and neuron-specific enolase. Neurofilament only showed a little positive in the hypocellular area, and silver impregnation was only noted in a perivascular distribution. The patient had no recurrence 4 months after the surgery. The rare variant of pituicytoma has a favourable prognosis. Moreover, it needs to be distinguished pituicytomas with pseudorosettes from ependymomas because of different prognosis. Lastly, Herring bodies may occasionally be seen in the pituicytoma, which could be a potential diagnostic pitfall.