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Welcoming the new WHO classification of pituitary tumors 2017: revolution in TTF-1-positive posterior pituitary tumors

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Abstract

The fourth edition of the World Health Organization classification of endocrine tumors (EN-WHO2017) was released in 2017. In this new edition, changes in the classification of non-neuroendocrine tumors are proposed particularly in tumors arising in the posterior pituitary. These tumors are a distinct group of low-grade neoplasms of the sellar region that express thyroid transcription factor-1, and include pituicytoma, granular cell tumor of the sellar region, spindle cell oncocytoma, and sellar ependymoma. This short review focuses on the classification of posterior pituitary tumors newly proposed in EN-WHO2017, and controversies in their pathological differential diagnosis are discussed based on recent cases.

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References

  1. Lloyd RV, Osamura RY, Kloppel G, Rosai J (2017) WHO classification of tumours of the endocrine organs, 4th edn. International Agency for Research on Cancer, Lyon

    Google Scholar 

  2. Mete O, Lopes MBS, Roncaroli F, Tihan T, Yamada S (2017) Tumours of the posterior pituitary. In: Lloyd RV, Osamura RY, Kloppel G, Rosai J (eds) WHO classification of tumours of endocrine organs, 4th edn. International Agency for Research on Cancer, Lyon, pp 52–54

    Google Scholar 

  3. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (2007) WHO classification of tumours of the central nervous system, 4th edn. International Agency for Research on Cancer, Lyon

    Google Scholar 

  4. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Ellison DW, Figarella-Branger D, Perry A, Reifenberger G, von Deimling A (2016) WHO classification of tumours of the central nervous system, Revised 4th edn. International Agency for Research on Cancer, Lyon

  5. Brat DJ, Wesseling P, Fuller GN, Roncaroli F (2016) Pituicytoma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Ellison DW, Figarella-Branger D, Perry A, Reifenberger G, von Deimling A (eds) WHO classification of tumours of the central nervous system, Revised 4th edn. International Agency for Research on Cancer, Lyon, pp 332–333

    Google Scholar 

  6. Brat DJ, Scheithauer BW, Staugaitis SM, Holtzman RNN, Morgello S, Burger PC (2000) Pituicytoma. A distinctive low-grade glioma of the neurophypophysis. Am J Surg Pathol 24:362–368

    Article  CAS  PubMed  Google Scholar 

  7. Fuller GN, Brat DJ, Wesseling P, Roncaroli F (2016) Granular cell tumor of the sellar region. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Ellison DW, Figarella-Branger D, Perry A, Reifenberger G, von Deimling A (eds) WHO classification of tumours of the central nervous system. Revised 4th edn. International Agency for Research on Cancer, Lyon, pp 329–331

    Google Scholar 

  8. Roncaroli F, Scheithauer BW, Cenacchi G, Horvath E, Kovasc K, Lloyd RV, Abell-Aleff P, Santi M, Yates AJ (2002) Spindle cell oncocytoma of the adenohypophysis. A tumor of follicullostellate cells? Am J Surg Pathol 26:1048–1055

    Article  PubMed  Google Scholar 

  9. Scheithauer BW, Swearingen B, Whyte ETH, Auluck PK, Stemmer-Rachamimov AO (2009) Ependymoma of the sellar turcica: a variant of pituicytoma. Hum Pathol 40:435–440

    Article  PubMed  Google Scholar 

  10. Lopes MBS, Fuller GN, Roncaroli F, Wesseling P (2016) Spindle cell oncocytoma. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Ellison DW, Figarella-Branger D, Perry A, Reifenberger G, von Deimling A (eds) WHO classification of tumours of the central nervous system, Revised 4th edn. International Agency for Research on Cancer, Lyon, pp 334–336

    Google Scholar 

  11. Yang X, Liu X, Li W, Chen D (2016) Pituicytoma: a report of three cases and literature review. Oncol Lett 12:3417–3422

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ahmed AK, Dawood HY, Penn DL, Smith TR (2017) Extent of surgical resection and tumor size predicts prognosis in granular cell tumor of the sellar region. Acta Neurochir 159:2209–2216

    Article  PubMed  Google Scholar 

  13. Manoranjan B, Koziarz A, Kameda-Smith MM, Provias JP (2017) Multiple recurrences required long-term follow-up in patients diagnosed with spindle cell oncocytoma of the sella turcica. J Clin Neurosci 43:134–146

    Article  PubMed  Google Scholar 

  14. 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. Am J Neuroradiol 32:2067–2072

    Article  CAS  PubMed  Google Scholar 

  15. Feng M, Carmichael JD, Bonert V, Bannykh S, Mamelak AN (2014) Surgical management of pituicytomas: case series and comprehensive literature review. Pituitary 17:399–413

    Article  PubMed  Google Scholar 

  16. Kleinschmidt-DeMasters BK, Lopes MBS (2013) Update on hypophysitis and TTF-1 expressing sellar region masses. Brain Pathol 23:495–514

    Article  PubMed  Google Scholar 

  17. Kong X, Li D, Kong Y, Zhong D (2017) Malignant adenohypophysis spindle cell oncocytoma with repeating recurrences and a high Ki-67 index. Medicine 96:e5657. https://doi.org/10.1097/MD.0000000000005657

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mete O, Lopes MB, Asa SL (2013) Spindle cell oncocytomas and granular cell tumors of the pituitary are variants of pituicytoma. Am J Surg Pathol 37:1694–1699

    Article  PubMed  Google Scholar 

  19. Vuong HG, Kondo T, Tran TM, Oishi N, Nakazawa T, Mochizuki K, Inoue T, Kasai K, Tahara I, Jieying W, Katoh R (2016) Spindle cell oncocytoma of adenohypophysis: Report of a case and immunohistochemical review of literature. Pathol Res Pract 212:222–225

    Article  PubMed  Google Scholar 

  20. Hussein SE, Vincentelli C (2017) Pituicytoma: Review of commonalities and distinguishing features among TTF-1 positive tumors of the central nervous system. Ann Diagn Pathol 29:57–61

    Article  PubMed  Google Scholar 

  21. Yoshimoto T, Takahashi-Fujigasaki J, Inoshita N, Fukuhara N, Nishioka H, Yamada S (2015) TTF-1 positive oncocytic sellar tumor with follicle formation/ependymal differentiation: non-adenomatous tumor capable of 2 different interpretations as a pituicytoma or a spindle cell oncocytoma. Brain Tumor Pathol 32:221–227

    Article  CAS  PubMed  Google Scholar 

  22. Lee EB, Tihan T, Scheithauer BW, Zhang PJ, Gonatas NK (2009) Thyroid transcription factor 1 expression in sellar tumors: A histogenic marker? J Neuropathol Exp Neurol 68:482–488

    Article  CAS  PubMed  Google Scholar 

  23. Takei Y, Seyama S, Pearl GS, Tindall GT (1980) Ultrastructural study of the human neurohypophysis. II. Cellular elements of neural parenchyma, the pituicytes. Cell Tissue Res 205:273–287

    Article  CAS  PubMed  Google Scholar 

  24. Miller MB, Bi WL, Ramkissoon LA, Kang YJ, Abedalthagafi M, Knoff DS, Agarwalla PK, Wen PY, Reardon DA, Alexander BM, Laws ER Jr, Dunn IF, Beroukhim R, Ligon KL, Ramkissoon SH (2016) MAPK activation and HRAS mutation identified in pituitary spindle cell oncocytoma. Oncotarget 7:37054–37063

    Article  PubMed  PubMed Central  Google Scholar 

  25. Suzuki R, Takano S, Akutsu H, Satomi K, Morishita Y, Takahashi A, Noguchi M, Matsumura A (2012) Granular cell tumor of the neurohypophysis observed with hypoglycemic attack. No Shinkei Geka 40:723–728 (Japanese)

    PubMed  Google Scholar 

  26. Zygourakis CC, Rolston JD, Lee HS, Partow C, Kunwar S, Aghi MK (2015) Pituicytomas and spindle cell oncocytomas: modern case series from the University of California. San Franc Pituit 18:150–158

    Article  Google Scholar 

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Acknowledgements

The author thanks Dr. Hiroyoshi Akutsu, Department of Neurosurgery, Tsukuba University, for his valuable clinical data, and medical editors of the Department of International Medical Communications of Tokyo Medical University for editing the manuscript.

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Correspondence to Makoto Shibuya.

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Shibuya, M. Welcoming the new WHO classification of pituitary tumors 2017: revolution in TTF-1-positive posterior pituitary tumors. Brain Tumor Pathol 35, 62–70 (2018). https://doi.org/10.1007/s10014-018-0311-6

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