Clinicopathological Analysis of Densely and Sparsely Granulated Somatotroph Tumors of Pituitary

World Neurosurg. 2024 May:185:e713-e720. doi: 10.1016/j.wneu.2024.02.115. Epub 2024 Feb 24.

Abstract

Objective: Somatotroph tumors are the second most common type of pituitary neuroendocrine tumors, which can be further classified into 2 subtypes-densely granulated somatotroph tumors (DGSTs) and sparsely granulated somatotroph tumors (SGSTs). The aim of this study was to investigate the clinical significance of the 2 subtypes in a retrospective analysis.

Methods: From the database of the Ningbo Clinical Pathology Diagnosis Center, we collected patients diagnosed with pituitary somatotroph tumors. We then compiled pertinent clinical and radiological data and proceeded with histopathological examination involving hematoxylin-eosin staining and immunohistochemical staining. Subsequent analysis compared the 2 subtypes using either χ2 test or Fisher exact test.

Results: We analyzed 40 cases of somatotroph tumors, 18 cases DGSTs and 22 SGSTs. Male-to-female ratio was 5:4 for DGSTs and 4:7 for SGSTs. Mean age was 52.83 years for DGSTs and 47.18 years for SGSTs. Statistically significant differences were observed between the DGST and SGST groups in invasiveness (P = 0.0267) and postoperative remission (P = 0.007). Cells of both DGSTs and SGSTs exhibited coexpression of PIT1, growth hormone, and CAM5.2, although the patterns of CAM5.2 expression differed between the 2 subtypes.

Conclusions: The efficacy of CAM5.2 staining in distinguishing between DGSTs and SGSTs was demonstrated. SGSTs, with their increased invasiveness and lower remission rate, are a high-risk subtype. The histological subtype of somatotroph tumors plays a crucial role in guiding treatment decisions and prognostic evaluation in affected patients.

Keywords: Adenoma; Growth hormone; Neuroendocrine tumor; Pituitary; Somatotroph tumor.

MeSH terms

  • Adenoma / pathology
  • Adult
  • Aged
  • Female
  • Growth Hormone-Secreting Pituitary Adenoma* / metabolism
  • Growth Hormone-Secreting Pituitary Adenoma* / pathology
  • Humans
  • Male
  • Middle Aged
  • Pituitary Neoplasms* / pathology
  • Pituitary Neoplasms* / surgery
  • Retrospective Studies
  • Somatotrophs / metabolism
  • Somatotrophs / pathology