A recurrent case of pituicytoma 16 years later

• Published in: Annals of the Royal College of Surgeons of England 2020-04, Vol.102 (4), p.e87-e88
• Main Authors: McNamara, K J, Shaw, S, Saravanappa, N
• Format: Article
• Language: English
• Subjects: Aged; Classification; Diagnostic Errors; Embolization; Endoscopy; Histology; Humans; Magnetic Resonance Imaging; Male; Meningioma - diagnosis; Meningioma - pathology; Meningioma - surgery; Natural history; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Nervous system; Online Case Report; Otolaryngology; Patients; Pituitary Gland, Posterior - diagnostic imaging; Pituitary Gland, Posterior - pathology; Pituitary Gland, Posterior - surgery; Pituitary Neoplasms - diagnosis; Pituitary Neoplasms - pathology; Pituitary Neoplasms - surgery; Proteins; Radiation therapy; Surveillance; Treatment Outcome; Tumors
• ISSN: 0035-8843; 1478-7083; 1478-7083
• DOI: 10.1308/rcsann.2020.0004

Pituicytoma is a rare; slow-growing primary tumour originating from the glial cells of the neurohypophysis. It was classed as a low-grade (grade I) central nervous system tumour by the World Health Organization in 2007. We present the case of a 71-year-old man with a previous history of sellar meningioma who underwent surgical resection of pituicytoma by transphenoidal hypophysectomy. We conducted a literature search using Medline EMBASE and the Cochrane Database of Systematic Reviews using the Ovid search engines. Key words searched were 'pituitary gland', 'pituicytoma', 'neurohypophysis'. Patient records and imaging were obtained from the Royal Stoke University Hospital database. A 71-year-old man with a background of sellar meningioma 16 years previously was found to have a pituitary fossa tumour on surveillance magnetic resonance imaging. Differential diagnosis was pituitary adenoma. Endoscopic transphenoidal hypophysectomy was performed. Histology was consistent with pituicytoma. As a result of this histology from his initial tumour was re-examined and was amended to pituicytoma, indicating a recurrence. Pituicytoma is a benign, slow growing lesion of the posterior pituitary. Brat diagnosed it as a distinct entity in 2000 and it was listed as a World Health Organization classification grade I tumour in 2007. It can be mistaken for pituitary adenoma owing to its similar clinical presentation. Complete excision of the tumour by transphenoidal hypophysectomy is an effective management for pituicytoma as demonstrated in this case.