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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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
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
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
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
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
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
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
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
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
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
Yang X, Liu X, Li W, Chen D (2016) Pituicytoma: a report of three cases and literature review. Oncol Lett 12:3417–3422
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
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
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
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
Kleinschmidt-DeMasters BK, Lopes MBS (2013) Update on hypophysitis and TTF-1 expressing sellar region masses. Brain Pathol 23:495–514
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
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
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
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
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
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
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
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
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)
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
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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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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DOI: https://doi.org/10.1007/s10014-018-0311-6