No abstract available.
Pathology* ; Pituitary Neoplasms*

Brain Neoplasms ; pathology ; Humans ; Pituitary Neoplasms ; pathology

Most chordomas involving the sellar region are parasellar or suprasellar, and largely or entirely sellar lesions are very rare. The authors report a case which chordoma involve pituitary fossa and surrounding structures and presented as nonfunctioning pituitary adenoma. Successful surgical removal was conducted via endonasal endoscopic approach. The pathology exhibited the typical histological patterns and immunophenotype of chordoma. The authors present a rare case of sellar chordoma and review the literature on that.
Chordoma* ; Pathology ; Pituitary Neoplasms* ; Sella Turcica

OBJECTIVES: Pituitary apoplexy is a well-described clinical syndrome resulting from pituitary hemorrhage, hemorrhagic infarction, or infarction, almost invariably occurring in the presence of an adenoma. We analyzed pituitary apoplexy with an emphasis on clinical presentation, pathology and predisposing factors. METHODS: We reviewed 35 histologically proven pituitary adenomas, operated from January 1995 to August 1999, to select 8 cases which showed clinical or operative findings compatible with pituitary apoplexy. These patients were analyzed in terms of symptom and sign, hormonal status, and predisposing factors, pathologic findings. RESULTS: Among 35 surgically treated tumors of the pituitary gland, 8 cases(23%) were diagnosed as pituitary apoplexy. The pathologic findings revealed hemorrhage(7 cases) and infarction(1 case) of pituitary adenomas. One case had predisposing factor of appendectomy. The most common presenting symptom and sign were sudden severe headache and visual disturbance. CONCLUSION: We treated pituitary apoplexy surgically and obtained good outcomes. Pituitary apoplexy due to massive infarction of the pituitary gland is very rare condition but surgical treatment by trans-spheniodal surgery showed a good result.
Adenoma ; Appendectomy ; Causality ; Headache ; Hemorrhage ; Humans ; Infarction ; Pathology ; Pituitary Apoplexy* ; Pituitary Gland ; Pituitary Neoplasms

Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; pathology ; physiopathology ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; pathology

The inflammatory lesion of the pituitary gland is unusual. A 33-year-old woman with headache, visual impairment, and menelipsis was admitted to the Second Xiangya Hospital, Central South University. The results of magnetic resonance imaging (MRI) for pituitary gland showed a sellar mass with iso-intensity on T1 weighted imaging and high signal on T2 weighted imaging. The homogeneous lesion was enhanced on contrast MRI. The pituitary stalk was thickened accompanied by the cavernous sinus invasion, which showed a "triangle" saddle occupation on the MRI coronal plane. An endocrinological examination revealed mild hypocortisolism. Th e patient was diagnosed as pituitary adenoma based on the MRI findings and endocrinological examination. Trans-sphenoidal surgery was performed. The intra-operative histological examination also suggested a pituitary adenoma. Th e histopathological examination showed accumulation of foamy cells and xanthomatous epithelioid cells, supporting the diagnosis of xanthomatous hypophysitis. Xanthomatous hypophysitis possesses certain MRI features. Th e most typical imaging features are the thickening of the pituitary stalk and the sign of "triangle" occupation on MRI coronal plane, which are very helpful to the correct diagnosis and optimal management.
Adenoma ; diagnosis ; Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Pituitary Diseases ; diagnosis ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; diagnosis

Objective: To investigate the clinicopathological characteristics of plurihormonal PIT1-lineage pituitary neuroendocrine tumors. Methods: Forty-eight plurihormonal PIT1-lineage tumors were collected between January 2018 and April 2022 from the pathological database of Sanbo Brain Hospital, Capital Medical University. The related clinical and imaging data were retrieved. H&E, immunohistochemical and special stains were performed. Results: Out of the 48 plurihormonal PIT1-lineage tumors included, 13 cases were mature PIT1-lineage tumors and 35 cases were immature PIT1-lineage tumors. There were some obvious clinicopathological differences between the two groups. Clinically, the mature plurihormonal PIT1-lineage tumor mostly had endocrine symptoms due to increased hormone production, while a small number of immature PIT1-lineage tumors had endocrine symptoms accompanied by low-level increased serum pituitary hormone; patients with the immature PIT1-lineage tumors were younger than the mature PIT1-lineage tumors; the immature PIT1-lineage tumors were larger in size and more likely invasive in imaging. Histopathologically, the mature PIT1-lineage tumors were composed of large eosinophilic cells with high proportion of growth hormone expression, while the immature PIT1-lineage tumors consisted of chromophobe cells with a relatively higher expression of prolactin; the mature PIT1-lineage tumors had consistently diffuse cytoplasmic positive staining for keratin, while the immature PIT1-lineage tumors had various expression for keratin; the immature PIT1-lineage tumors showed more mitotic figures and higher Ki-67 proliferation index; in addition, 25.0% (12/48) of PIT1-positive plurihormonal tumors showed abnormal positive staining for gonadotropin hormones. There was no significant difference in the progression-free survival between the two groups (P=0.648) by Kaplan-Meier analysis. Conclusions: Plurihormonal PIT1-lineage tumor belongs to a rare type of PIT1-lineage pituitary neuroendocrine tumors, most of which are of immature lineage. Clinically increased symptoms owing to pituitary hormone secretion, histopathologically increased number of eosinophilic tumor cells with high proportion of growth hormone expression, diffusely cytoplasmic keratin staining and low proliferative activity can help differentiate the mature plurihormonal PIT1-lineage tumors from the immature PIT1-lineage tumors. The immature PIT1-lineage tumors have more complicated clinicopathological characteristics.
Humans ; Neuroendocrine Tumors ; Pituitary Neoplasms/pathology* ; Pituitary Hormones ; Growth Hormone/metabolism* ; Keratins

Adenoma ; diagnosis ; Child ; Diagnosis, Differential ; Humans ; Hypothyroidism ; pathology ; Magnetic Resonance Imaging ; Male ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; diagnosis

Hemangioblastoma (HBL) in the pituitary stalk is extremely rare. Only 16 such cases have been reported in the past and 5 cases have been treated with surgical procedure. Here, we report surgical case of HBL in the pituitary stalk diagnosed in a 34-year-old woman. The patient underwent a gross-total resection via the modified lateral supra-orbital approach. No recurrence was observed in two years after surgery. To our knowledge, this is the 17th case of HBL in the pituitary stalk and the 6th surgical case. If the tumor is symptomatic and the volume is over 5 cubic centimeters as in our case, we recommend that the surgical resection of the HBL in the pituitary stalk is a more safe and reasonable than radiotherapy.
Adult ; Cerebellar Neoplasms/pathology/*surgery ; Female ; Hemangioblastoma/pathology/*surgery ; Humans ; Pituitary Gland/*pathology ; Treatment Outcome

We report a very rare case of atypical granular cell tumor arising in the neurohypophysis of a 56-year-old woman. The tumor was seen on radiology to be lobulated, soft and diffusely enhanced, the same as pituitary macroadenoma, but it was anatomically localized within the posterior part of the hypophysis. We partially removed the tumor via the transsphenoidal approach. The pathology showed nuclear pleomorphism, spindling features, and lymphoplasmacytic infiltration. Ki-67 and S-100 protein were focally positive in tumor cells. Histological diagnosis confirmed an atypical granular cell tumor in the sellar region, which is a rare tumor that often has the clinical appearance of a pituitary adenoma. Ophthalmologic symptoms are the most common, followed by endocrinologic manifestations. Here we describe its symptoms and radiological and pathological features.
Central Nervous System ; Diagnosis ; Female ; Granular Cell Tumor* ; Humans ; Middle Aged ; Pathology ; Pituitary Gland ; Pituitary Gland, Posterior ; Pituitary Neoplasms ; S100 Proteins