, Volume 17, Issue 5, pp 399–413 | Cite as

Surgical management of pituicytomas: case series and comprehensive literature review

  • Ming Feng
  • John D. Carmichael
  • Vivien Bonert
  • Serguei Bannykh
  • Adam N. MamelakEmail author



Pituicytomas are rare neoplasms that typically present as solid, noninfiltrative tumors occupying the sella and/or suprasellar space for which there is no consensus on optimal surgical management. We aimed to define a preferred surgical strategy for these tumors based on our clinical experience and comprehensive review of the world literature.


Case series and review of the literature.


We documented the clinical, radiographic, and surgical findings of three patients with pituicytoma treated at our institution, as well as complications and long-term outcomes. A comprehensive review of the medical literature identified all cases of pituicytoma for which data regarding surgical approach, outcome and complications could be extracted. We compared our results with published data.


All three cases at our institution achieved gross total removal. Two patients underwent an expanded endoscopic endonasal transsphenoidal and transplanum (EETS-TP) approach, while one tumor was removed via craniotomy. Post-operatively all patients developed pan-hypopitutarism. The patient undergoing craniotomy suffered profound visual loss but no other neurological complications were noted. A literature review identified 67 reported cases of pituicytoma. Surgical data was available in 60 cases. Surgical approach was documented in 57 patients. Sixty-three surgeries were performed in which approach and extent of resection was available. Gross total removal was obtained in 33 % of craniotomies, 42 % of transsphenoidal procedures, and 100 % of expanded transsphenoidal procedures. Neurological complications including visual loss, hemiparesis and cranial nerve palsies were reported after craniotomy, but not after transsphenoidal approaches. Overall EETS-TP approaches were associated with the highest rate of gross total removal and no visual or neurological complications.


EETS-TP surgery is the preferred strategy for surgical removal of pituicytoma. EETS-TP and transsphenoidal approaches are associated with higher rates of gross total removal and lower rates of neurological complications than craniotomy. Gross total removal should be the intended goal of surgery.


Pituicytoma Outcome Complications Endoscope Transsphenoidal Craniotomy 



Cerebrospinal fluid


Epithelial membrane antigen


Glial fibrillary acidic protein


Diabetes insipidus






Endoscopic endonasal transsphenoidal transplanum


Conflict of interest

The authors report no conflicts of interest or financial disclosures/nothing to declare.


  1. 1.
    Chu J, Yang Z, Meng Q, Yang J (2011) Pituicytoma: case report and literature review. Br J Radiol 84:e55–e57CrossRefPubMedGoogle Scholar
  2. 2.
    Covington MF, Chin SS, Osborn AG (2011) Pituicytoma, spindle cell oncocytoma, and granular cell tumor: clarification and meta-analysis of the world literature since 1893. AJNR Am J Neuroradiol 32:2067–2072CrossRefPubMedGoogle Scholar
  3. 3.
    Grote A, Kovacs A, Clusmann H, Becker AJ, Niehusmann P (2010) Incidental pituicytoma after accidental head trauma—case report and review of literature. Clin Neuropathol 29:127–133CrossRefPubMedGoogle Scholar
  4. 4.
    Schmalisch K, Schittenhelm J, Ebner FH, Beuschlein F, Honegger J, Beschorner R (2012) Pituicytoma in a patient with Cushing’s disease: case report and review of the literature. Pituitary 15(Suppl 1):S10–S16CrossRefPubMedGoogle Scholar
  5. 5.
    Secci F, Merciadri P, Rossi DC, D’Andrea A, Zona G (2012) Pituicytomas: radiological findings, clinical behavior and surgical management. Acta Neurochir (Wien) 154:649–657, discussion 657Google Scholar
  6. 6.
    Chakraborti S, Mahadevan A, Govindan A, Sridhar K, Mohan NV, Satish IR, Rudrappa S, Mangshetty S, Shankar SK (2013) Pituicytoma: report of three cases with review of literature. Pathol Res Pract 209:52–58CrossRefPubMedGoogle Scholar
  7. 7.
    Uesaka T, Miyazono M, Nishio S, Iwaki T (2002) Astrocytoma of the pituitary gland (pituicytoma): case report. Neuroradiology 44:123–125CrossRefPubMedGoogle Scholar
  8. 8.
    Cowan DF, Haubold EM, Tajima Y (2008) Histological, immunohistochemical and pathological features of the pituitary gland of odontocete cetaceans from the Western Gulf of Mexico. J Comp Pathol 139:67–80CrossRefPubMedGoogle Scholar
  9. 9.
    Watanabe K (2000) Granular-cell tumor (choristoma, pituicytoma). Ryoikibetsu Shokogun Shirizu 28(Pt 3):218–219 Google Scholar
  10. 10.
    Ellis JA, Tsankova NM, D’Amico R, Ausiello JC, Canoll P, Rosenblum MK, Bruce JN (2012) Epithelioid pituicytoma. World Neurosurg 78(191):E191–E197Google Scholar
  11. 11.
    Scheithauer BW, Swearingen B, Whyte ET, Auluck PK, Stemmer-Rachamimov AO (2009) Ependymoma of the sella turcica: a variant of pituicytoma. Hum Pathol 40:435–440CrossRefPubMedGoogle Scholar
  12. 12.
    Katsuta T, Inoue T, Nakagaki H, Takeshita M, Morimoto K, Iwaki T (2003) Distinctions between pituicytoma and ordinary pilocytic astrocytoma: case report. J Neurosurg 98:404–406CrossRefPubMedGoogle Scholar
  13. 13.
    Chen KT (2005) Crush cytology of pituicytoma. Diagn Cytopathol 33:255–257CrossRefPubMedGoogle Scholar
  14. 14.
    Kanaya H, Kojima K, Katsura S, Hamatsu Y, Tsuchikawa G (1967) Case of pituicytoma. No To Shinkei 19:1015–1020PubMedGoogle Scholar
  15. 15.
    Huang Y, Quan J, Su H, Hu HX, Wang F (2012) 40-year old female with a sellar mass. Brain Pathol 22:871–874CrossRefPubMedGoogle Scholar
  16. 16.
    Yilmaz O, Turan A, Yigit H, Duymus M, Kosar U (2012) Case of pituicytoma in childhood. Childs Nerv Syst 28:11–12CrossRefPubMedGoogle Scholar
  17. 17.
    Furtado SV, Ghosal N, Venkatesh PK, Gupta K, Hegde AS (2010) Diagnostic and clinical implications of pituicytoma. J Clin Neurosci 17:938–943CrossRefPubMedGoogle Scholar
  18. 18.
    Hurley TR, D’Angelo CM, Clasen RA, Wilkinson SB, Passavoy RD (1994) Magnetic resonance imaging and pathological analysis of a pituicytoma: case report. Neurosurgery 35:314–317, discussion 317Google Scholar
  19. 19.
    Ulm AJ, Yachnis AT, Brat DJ, Rhoton Jr AL (2004) Pituicytoma: report of two cases and clues regarding histogenesis. Neurosurgery 54:753–757, discussion 757–758Google Scholar
  20. 20.
    Gibbs WN, Monuki ES, Linskey ME, Hasso AN (2006) Pituicytoma: diagnostic features on selective carotid angiography and MR imaging. AJNR Am J Neuroradiol 27:1639–1642PubMedGoogle Scholar
  21. 21.
    Takei H, Goodman JC, Tanaka S, Bhattacharjee MB, Bahrami A, Powell SZ (2005) Pituicytoma incidentally found at autopsy. Pathol Int 55:745–749CrossRefPubMedGoogle Scholar
  22. 22.
    Kwon MJ, Suh YL (2011) Pituicytoma with unusual histological features. Pathol Int 61:598–602CrossRefPubMedGoogle Scholar
  23. 23.
    Pirayesh Islamian A, Buslei R, Saeger W, Fahlbusch R (2012) Pituicytoma: overview of treatment strategies and outcome. Pituitary 15:227–236CrossRefPubMedGoogle Scholar
  24. 24.
    Liss L, Kahn EA (1958) Pituicytoma, tumor of the sella turcica; a clinicopathological study. J Neurosurg 15:481–488CrossRefPubMedGoogle Scholar
  25. 25.
    Kowalski RJ, Prayson RA, Mayberg MR (2004) Pituicytoma. Ann Diagn Pathol 8:290–294CrossRefPubMedGoogle Scholar
  26. 26.
    Brandao RA, Braga MH, de Souza AA, Reis BL, Faraj de Lima FB (2010) Pituicytoma. Surg Neurol Int 1:79CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Zhang F, Chen J, You C (2010) Pituicytoma: case report and review of the literature. Neurol India 58:799–801CrossRefPubMedGoogle Scholar
  28. 28.
    Rivero-Celada D, Barrera-Rojas M, Orduna-Martinez J, Lorente-Munoz A, Alfaro-Torres J, Alberdi-Vinas J (2012) Pituitary pituicytoma. Neurocirugia (Astur) 23:165–169CrossRefGoogle Scholar
  29. 29.
    Shah B, Lipper MH, Laws ER, Lopes MB, Spellman MJ Jr (2005) Posterior pituitary astrocytoma: a rare tumor of the neurohypophysis: a case report. AJNR Am J Neuroradiol 26:1858–1861PubMedGoogle Scholar
  30. 30.
    Ogiwara H, Dubner S, Shafizadeh S, Raizer J, Chandler JP (2011) Spindle cell oncocytoma of the pituitary and pituicytoma: two tumors mimicking pituitary adenoma. Surg Neurol Int 2:116CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Wolfe SQ, Bruce J, Morcos JJ (2008) Pituicytoma: case report. Neurosurgery 63:E173–E174, discussion E174Google Scholar
  32. 32.
    Schultz AB, Brat DJ, Oyesiku NM, Hunter SB (2001) Intrasellar pituicytoma in a patient with other endocrine neoplasms. Arch Pathol Lab Med 125:527–530PubMedGoogle Scholar
  33. 33.
    Mao Z, Xiao W, Wang H, Li Z, Huang Q, He D, Zhu Y (2011) Pituicytoma: report of two cases. Oncol Lett 2:37–41PubMedPubMedCentralGoogle Scholar
  34. 34.
    Nishizawa S, Yokoyama T, Hinokuma K, Ohta S, Uemura K, Takahashi H (1997) Pituitary astrocytoma: magnetic resonance and hormonal characteristics: case illustration. J Neurosurg 87:131CrossRefPubMedGoogle Scholar
  35. 35.
    Huynh N, Stemmer-Rachamimov AO, Swearingen B, Cestari DM (2012) Decreased vision and junctional scotoma from pituicytoma: case report. Ophthalmol 3:190–196Google Scholar
  36. 36.
    Kosuge Y, Hiramoto J, Morishima H, Tanaka Y, Hashimoto T (2012) Neuroimaging characteristics and growth pattern on magnetic resonance imaging in a 52-year-old man presenting with pituicytoma: a case report. J Med Case Rep 6:306CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Cusick JF, Ho KC, Hagen TC, Kun LE (1982) Granular-cell pituicytoma associated with multiple endocrine neoplasia type. J Neurosurg 56:594–596CrossRefPubMedGoogle Scholar
  38. 38.
    Newnham HH, Rivera-Woll LM (2008) Images in clinical medicine. Hypogonadism due to pituicytoma in an identical twin. N Engl J Med 359:2824CrossRefPubMedGoogle Scholar
  39. 39.
    Hammoud DA, Munter FM, Brat DJ, Pomper MG (2010) Magnetic resonance imaging features of pituicytomas: analysis of 10 cases. J Comput Assist Tomogr 34:757–761CrossRefPubMedGoogle Scholar
  40. 40.
    Brat DJ, Scheithauer BW, Staugaitis SM, Holtzman RN, Morgello S, Burger PC (2000) Pituicytoma: a distinctive low-grade glioma of the neurohypophysis. Am J Surg Pathol 24:362–368CrossRefPubMedGoogle Scholar
  41. 41.
    Rossi ML, Bevan JS, Esiri MM, Hughes JT, Adams CB (1987) Pituicytoma (pilocytic astrocytoma): case report. J Neurosurg 67:768–772CrossRefPubMedGoogle Scholar
  42. 42.
    Benveniste RJ, Purohit D, Byun H (2006) Pituicytoma presenting with spontaneous hemorrhage. Pituitary 9:53–58CrossRefPubMedGoogle Scholar
  43. 43.
    Nakasu Y, Nakasu S, Saito A, Horiguchi S, Kameya T (2006) Pituicytoma. Two case reports. Neurol Med Chir (Tokyo) 46:152–156CrossRefGoogle Scholar
  44. 44.
    Figarella-Branger D, Dufour H, Fernandez C, Bouvier-Labit C, Grisoli F, Pellissier JF (2002) Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis: report of three cases. Acta Neuropathol 104:313–319PubMedGoogle Scholar
  45. 45.
    Brat DJ, Scheithauer BW, Fuller GN, Tihan T (2007) Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. Brain Pathol 17:319–324CrossRefPubMedGoogle Scholar
  46. 46.
    Munich SA, Fenstermaker RA, Fabiano AJ, Rigual NR (2013) Cranial base repair with combined vascularized nasal septal flap and autologous tissue graft following expanded endonasal endoscopic neurosurgery. J Neurol Surg A Cent Eur Neurosurg 74(2):101–108Google Scholar
  47. 47.
    Phillips JJ, Misra A, Feuerstein BG, Kunwar S, Tihan T (2010) Pituicytoma: characterization of a unique neoplasm by histology, immunohistochemistry, ultrastructure, and array-based comparative genomic hybridization. Arch Pathol Lab Med 134:1063–1069PubMedPubMedCentralGoogle Scholar
  48. 48.
    Cenacchi G, Giovenali P, Castrioto C, Giangaspero F (2001) Pituicytoma: ultrastructural evidence of a possible origin from folliculo-stellate cells of the adenohypophysis. Ultrastruct Pathol 25:309–312CrossRefPubMedGoogle Scholar
  49. 49.
    Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH (2012) Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas. World Neurosurg 77:329–341CrossRefPubMedGoogle Scholar
  50. 50.
    Elliott RE, Jane Jr JA, Wisoff JH (2011) Surgical management of craniopharyngiomas in children: meta-analysis and comparison of transcranial and transsphenoidal approaches. Neurosurgery 69:630–643, discussion 643Google Scholar
  51. 51.
    Mascarenhas L, Moshel YA, Bayad F, Szentirmai O, Salek AA, Leng LZ, Hofstetter CP, Placantonakis DG, Tsiouris AJ, Anand VK, Schwartz TH (2013) The transplanum transtuberculum approaches for suprasellar and sellar-suprasellar lesions: avoidance of cerebrospinal fluid leak and lessons learned. World Neurosurg. doi: 10.1016/j.wneu.2013.02.032
  52. 52.
    Barazi SA, Pasquini E, D’Urso PI, Zoli M, Mazzatenta D, Sciarretta V, Frank G (2013) Extended endoscopic transplanum-transtuberculum approach for pituitary adenomas. Br J Neurosurg 27:374–382CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ming Feng
    • 1
  • John D. Carmichael
    • 2
  • Vivien Bonert
    • 2
  • Serguei Bannykh
    • 3
  • Adam N. Mamelak
    • 4
    Email author
  1. 1.Department of NeurosurgeryPeking Union Medical College HospitalBeijingChina
  2. 2.Endocrinology Division, Department of MedicineCedars-Sinai Medical CenterLos AngelesUSA
  3. 3.Department of PathologyCedars-Sinai Medical CenterLos AngelesUSA
  4. 4.Department of NeurosurgeryCedars-Sinai Medical CenterLos AngelesUSA

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