Two Extraordinary Sellar Neuronal Tumors: Literature Review and Comparison of Clinicopathologic Features

Am J Clin Pathol. 2019 Feb 4;151(3):241-254. doi: 10.1093/ajcp/aqy155.

Abstract

Objectives: The list of tumors involving the pituitary gland has been expanded to include a variety of neuronal and paraneuronal tumors in the 2017 World Health Organization tumor classification of endocrine organs. All the entities included in this category are distinctly rare, with limited case reports in the literature.

Methods: We illustrate two extraordinary sellar tumors with neuronal differentiation: a sellar paraganglioma and a sellar neurocytoma, with thorough literature review and comparison of the clinicopathologic features of these entities.

Results: Both entities are exceptionally rare and tend to be misdiagnosed as pituitary adenoma preoperatively. Both entities demonstrate frequent clinical recurrence compared with pituitary adenoma, as well as the rare occurrence of metastatic disease.

Conclusions: In evaluating a sellar tumor with an uncommon morphology and neuroendocrine differentiation, an increased awareness of the unusual entities that may involve the sellar region and a judicious panel of immunohistochemical studies should improve the diagnosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma / classification
  • Adenoma / diagnostic imaging
  • Adenoma / pathology*
  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neuroendocrine Tumors / classification
  • Neuroendocrine Tumors / diagnostic imaging
  • Neuroendocrine Tumors / pathology*
  • Paraganglioma / classification
  • Paraganglioma / diagnostic imaging
  • Paraganglioma / pathology*
  • Pituitary Neoplasms / classification
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / pathology*
  • Sella Turcica / diagnostic imaging
  • Sella Turcica / pathology
  • World Health Organization