Tumors of the Neurohypophysis: One Unit's Experience and Literature Review

World Neurosurg. 2020 Feb:134:e968-e978. doi: 10.1016/j.wneu.2019.11.043. Epub 2019 Nov 14.

Abstract

Objective: To evaluate and understand the clinical behavior and radiologic correlates of tumors originating from the posterior pituitary gland. To review the management strategy for these rare tumors and add to the limited existing literature.

Methods: Retrospective review of 8 cases (5 pituicytomas, 2 spindle cell oncocytomas, and 1 granular cell tumor) managed at our institution between 2004 and 2019. The patients' clinical course, histologic features, and radiologic findings were reviewed. Their management and long-term follow-up is presented and compared with the literature.

Results: Long-term follow-up ranged from 1 to 9 years. There was 1 recurrence in a patient with spindle cell oncocytoma, and this was treated with radiotherapy. The endoscopically managed cases resulted in complete tumor excision with no recurrence.

Conclusions: Epidemiologic data on primary tumors of the neurohypophysis is limited because of the rarity of these tumors. This study adds to the literature that these tumors behave as World Health Organization grade I tumors, although close follow-up is recommended as a few cases have shown recurrence. The endoscopic approach resulted in better gross total tumor resection rate in this series.

Keywords: Granular cell tumor; Neurohypophysis; Pituicytoma; Sellar region; Spindle cell oncocytoma; Transsphenoidal surgery.

Publication types

  • Review

MeSH terms

  • Adenoma, Oxyphilic / complications
  • Adenoma, Oxyphilic / pathology*
  • Adenoma, Oxyphilic / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebral Intraventricular Hemorrhage / etiology
  • Cytoreduction Surgical Procedures
  • Female
  • Glioma / complications
  • Glioma / pathology*
  • Glioma / surgery
  • Granular Cell Tumor / complications
  • Granular Cell Tumor / pathology*
  • Granular Cell Tumor / surgery
  • Hemianopsia / etiology
  • Humans
  • Hypogonadism / etiology
  • Incidental Findings
  • Male
  • Microsurgery
  • Middle Aged
  • Neoplasm, Residual
  • Neuroendoscopy
  • Pituitary Gland, Posterior / cytology
  • Pituitary Gland, Posterior / pathology*
  • Pituitary Gland, Posterior / surgery
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / pathology*
  • Pituitary Neoplasms / surgery
  • Sphenoid Bone