Recommendation to improve the WHO classification of posterior pituitary tumors as a unique entity: evidence from a large case series

Nidan Qiao; Haixia Cheng; Zhaoyun Zhang; Hongying Ye; Ming Shen; Xuefei Shou; Xiaoyun Cao; Hong Chen; Xiang Zhou; Yongfei Wang; Yao Zhao

doi:10.1530/EC-22-0188

Endocrine Connections (Jun 2022)

Recommendation to improve the WHO classification of posterior pituitary tumors as a unique entity: evidence from a large case series

Nidan Qiao,
Haixia Cheng,
Zhaoyun Zhang,
Hongying Ye,
Ming Shen,
Xuefei Shou,
Xiaoyun Cao,
Hong Chen,
Xiang Zhou,
Yongfei Wang,
Yao Zhao

Affiliations

Nidan Qiao: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
Haixia Cheng: Department of Pathology, Huashan Hospital, Shanghai Medical School, Shanghai, China
Zhaoyun Zhang: Department of Endocrinology, Huashan Hospital, Shanghai Medical School, Shanghai, China
Hongying Ye: Department of Endocrinology, Huashan Hospital, Shanghai Medical School, Shanghai, China
Ming Shen: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
Xuefei Shou: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
Xiaoyun Cao: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
Hong Chen: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China; Department of Pathology, Huashan Hospital, Shanghai Medical School, Shanghai, China
Xiang Zhou: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
Yongfei Wang: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
Yao Zhao: Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China

DOI: https://doi.org/10.1530/EC-22-0188
Journal volume & issue: Vol. 11, no. 6
pp. 1 – 9

Abstract

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Introduction: Most studies reporting posterior pituitary tumors (PPTs) are small case series or single cases. Methods: Patients with a histological diagnosis of PPT from January 2010 to December 2021 in a tertiary center were identified. We reported clinical symptoms, endocrine assessments, radiological and pathological features, and surgical outcomes of PPTs. Results: A total of 51 patients (23 males, 51.3 ± 10.3 years old) with PPT were included in this study. Major symptoms were visual defects, headache, and hypopituitarism, while diabetes insipidus was uncommon (9.8%). The typical radiological feature was homogeneous enhancement (84.3%) of a regular-shaped mass on T1 contrast imaging without cystic change, calcification, or cavernous sinus invasio n. We achieved gross total resection in 38/51 patients (74.5%). Pathologically, all tumors showed thyroid transcription factor 1 immunoreactivity. Among 29 patients with suprasellar PPTs, postoperative hemorrhage due to tumor residue was encountered in 2/15 cases in the transcranial group and 0/14 in the endoscopy group. Patients with spindle cell oncocytoma (SCO) were more likely to be surgically treated (25% vs 0%, P = 0.018), harbor a higher Ki-67 index (16.7% vs 0% > 5% P = 0.050), and present a lower 2-year recurrence-free survival rate (67.5% vs 90.9%) compared with patients with pituicytoma or granular cell tumor. Conclusion: PPTs should be considered in the differential diagnosis of pati ents with sellar and suprasellar masses with a regular lesion with homogeneous enhancement. SCOs had high proliferation activity and risk of recurrence.

Published in Endocrine Connections

ISSN: 2049-3614 (Online)
Publisher: Bioscientifica
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: http://www.endocrineconnections.com/

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